Modmed India hiring Multispeciality denail coding specialist - Hyd loc

ModMed Technologies India Private Limited; Hyderabad; On-site; INR 900,000 - 1,800,000; Full time

Job summary

ModMed invites a skilled RCM Coding Specialist to join our Hyderabad team. This SME role spans the entire Revenue Cycle Management, ensuring accurate, compliant coding and denials reduction while bridging our global partners and US-based teams.

You will audit coding, manage denials, apply payer guidelines, and drive continuous improvement across Gastroenterology, Orthopedics, Ophthalmology, Dermatology and Podiatry to improve patient outcomes and practice success.

Qualifications

• Bachelor's or Master’s in Human Science or related field; anatomy background.
• CPC or CCS certification mandatory.
• 5+ years in Provider RCM.
• Minimum 2 years as QA/SME in medical coding.
• Expert CPT/ICD code knowledge with modifiers.
• Strong payer guideline knowledge and denials resolution.
• Specialized knowledge in Gastroenterology, Orthopedics, Ophthalmology, Dermatology, and Podiatry.

Responsibilities

• Quality Assurance & Auditing: Audit coding performed by Global Partners and provide timely feedback to resolve denied claims quickly.
• Denial Management: Review and resolve coding denials from payers, ensuring accurate resubmission and revenue recovery.
• Subject Matter Expertise: Act as the primary point of contact for coding questions and clarifications for the MMI team.
• Trend Analysis: Review claims assigned to practices due to coding issues to identify trends; collaborate with Client Advisors when practice education or intervention is needed.
• Preventive Strategy: Analyze denial data to recommend preventive measures, such as scrub edits, provider training, and internal action plans.
• Continuous Learning: Stay current with Payer Guidelines and participate in ongoing coding educational opportunities and webinars.
• Production Support: Assist in production coding for various client specialties and scopes as needed.

Skills

English communication

Independent work

Cross-country collaboration

MS Excel

Education

Bachelor/Master in Human Science or related field

Job description

Job Description - RCM Coding Specialist(Multispeciality denial coding specialist role)

Location: Hyderabad,

Work from office

Reports to: Manager ( Medical Coding)

Who We Are

At ModMed, we are on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical-practice success and improves patient outcomes.

We live by our core values:

• Create Customer Delight and Save Time.
• Innovate Boldly, then make things happen.
• Align Passion with Purpose.
• Think Big. Have Fun. Do Good.

The Role

The RCM Coding Specialist is a vital new role designed to make our team self-sufficient across the entire Revenue Cycle Management (RCM) cycle. This position serves as a Subject Matter Expert (SME), ensuring that medical coding is accurate, compliant, and optimized to reduce denials. You will bridge the gap between our global partners and US-based teams, providing the technical expertise necessary to improve patient outcomes and practice success.

What Youll Do

• Quality Assurance & Auditing : Audit coding performed by Global Partners and provide timely feedback to resolve denied claims quickly.
• Denial Management : Review and resolve coding denials from payers, ensuring accurate resubmission and revenue recovery.
• Subject Matter Expertise : Act as the primary point of contact for coding questions and clarifications for the MMI team.
• Trend Analysis : Review claims assigned to practices due to coding issues to identify trends; collaborate with Client Advisors (CAs) when practice education or intervention is needed.
• Preventive Strategy : Analyze denial data to recommend preventive measures, such as scrub edits, provider training, and internal action plans.
• Continuous Learning : Stay current with Payer Guidelines and participate in ongoing coding educational opportunities and webinars.
• Production Support : Assist in production coding for various client specialties and scopes as needed.

What You Bring

• Education & Certification: * Bachelors or Master’s degree in Human Science (Anatomy background), B.Sc, M.Sc, or B.Pharma.
• Certification mandatory - CPC/CCS
• Experience: * At least 5 years of overall experience in Provider RCM.
• A minimum of 2 years of core experience as a QA or SME within a Medical coding department.
• Specialized Knowledge: * Expert-level knowledge in supplying, auditing, and analyzing CPT and ICD codes with appropriate modifiers.
• Proven ability to resolve coding-related denials and a deep understanding of payer guidelines.
• Strong coding knowledge in specialties including Gastroenterology, Orthopedics, Ophthalmology, Dermatology, and Podiatry.

Skills

• Excellent written and verbal English communication skills.
• Ability to work independently and collaborate effectively across multiple countries.
• Strong analytical skills with proficiency in MS Excel for reporting and trend analysis.