RCM Coding Specialist

ModMed Technologies India Private Limited; Hyderabad; On-site; INR 1,500,000 - 2,100,000; Full time

Benefits offered by this job

Meals & Snacks

Insurance Coverage

Annual Wellness Allowance

Paid leaves

Job summary

ModMed Technologies India Private Limited is seeking a RCM Coding Specialist in Hyderabad to ensure accurate CPT/ICD coding and minimize denials. You will serve as SME, bridging global partners and US teams, with emphasis on QA, trend analysis, and prevention strategies.

The role requires 5+ years in Provider RCM, CPC/CCS preferred, and strong Excel skills for reporting. You will collaborate across countries and contribute to improved patient outcomes and practice success.

Qualifications

• Bachelor’s or Master’s degree in Human Science (Anatomy background) or related field.
• CPC (AAPC) or CCS (AHIMA) certification is highly preferred.
• Experience in Provider RCM and QA/SME roles is essential.

Responsibilities

• Quality Assurance & Auditing of coding by Global Partners and provide feedback to resolve denials.
• Denial Management: review and resolve coding denials to recover revenue.
• Act as SME; primary contact for coding questions for MMI team.
• Trend Analysis: identify coding trend patterns and coordinate with Client Advisors for education/interventions.
• Develop Preventive Strategy through denial data analysis, scrubs, training and action plans.
• Maintain Continuous Learning by staying updated on payer guidelines and coding education.
• Provide Production Support by assisting in coding for various client specialties.

Skills

English communication

Independent work

Analytical skills

Education

Bachelor’s/Master’s in Human Science (Anatomy)

B.Sc./M.Sc./B.Pharma

CPC (AAPC) or CCS (AHIMA) certification

Tools

MS Excel

Job description

Job Description Summary

RCM Coding Specialist

Location: Hyderabad

Reports to: Sr. Manager, MMI (Administrative) | Manager, Medical

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 You’ll Do

• Quality Assurance & Auditing (25%): Audit coding performed by Global Partners and provide timely feedback to resolve denied claims quickly.
• Denial Management (20%): Review and resolve coding denials from payers, ensuring accurate resubmission and revenue recovery.
• Subject Matter Expertise (20%): Act as the primary point of contact for coding questions and clarifications for the MMI team.
• Trend Analysis (15%): 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 (10%): Analyze denial data to recommend preventive measures, such as scrub edits, provider training, and internal action plans.
• Continuous Learning (5%): Stay current with Payer Guidelines and participate in ongoing coding educational opportunities and webinars.
• Production Support (5%): Assist in production coding for various client specialties and scopes as needed.

What You Bring

Education & Certification

• Bachelor’s or Master’s degree in Human Science (Anatomy background), B.Sc, M.Sc, or B.Pharma.
• CPC (AAPC) or CCS (AHIMA) certification is highly preferred.

Experience

• At least 5 years of overall experience in Provider RCM.
• Minimum of 2 years of core experience as a QA or SME within a 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.

Why Join ModMed?

You will be an integral part of a team that empowers medical practices to thrive. By ensuring coding accuracy, you directly contribute to our goal of saving time for doctors and improving the healthcare experience for patients.

Benefits Highlight

• Meals & Snacks: Complimentary office lunches & dinners on select days and healthy snacks delivered to your desk.
• Insurance Coverage: Comprehensive health, accidental, and life insurance plans, including coverage for family members.
• Annual Wellness Allowance to support well‑being and productivity.
• Earned, casual, and sick leave to maintain a healthy work‑life balance.
• Bereavement leave for difficult times and extended medical leave options.
• Paid parental leaves, including maternity, paternity, adoption, surrogacy, and abortion leave.
• Celebration leave to make your special day memorable.
• Company‑paid holidays for recharge and unwind.

Equal Opportunity Employer

ModMed is an equal‑opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.