RCM Coding Specialist

Enboarder; Hyderabad; On-site; INR 1,200,000 - 1,800,000; Full time

Benefits offered by this job

Meals & Snacks

Health, accidental & life insurance

Wellness allowance

Leave benefits

Parental leave

Company holidays

Job summary

ModMed in Hyderabad seeks a Senior RCM Coding Specialist to ensure accurate, compliant coding across the Revenue Cycle. You will serve as SME, bridging global partners and US teams to improve patient outcomes and practice success.

You will audit, manage denials, provide guidance on CPT/ICD codes, and analyze trends to drive preventive strategies. Requires 5+ years in provider RCM, CPC/CCS preferred, and strong English communication.

Qualifications

• 5+ years of Provider RCM experience.
• Minimum 2 years as QA or SME in a Coding Department.
• Expert knowledge in CPT/ICD coding with modifiers.
• Strong understanding of payer guidelines.
• Specialties: Gastroenterology, Orthopedics, Ophthalmology, Dermatology, and Podiatry.

Responsibilities

• Quality Assurance & Auditing of coding performed by Global Partners and provide feedback to resolve denied claims.
• Denial Management: review and resolve coding denials with accurate resubmission and revenue recovery.
• Act as the primary SME for coding questions for the MMI team.
• Trend Analysis: identify coding issue trends and collaborate with Client Advisors for education/intervention.
• Preventive Strategy: recommend scrub edits and provider training based on denial data.
• Continuing Education: stay updated with payer guidelines and coding education opportunities.
• Production Support: assist in production coding for various client specialties as needed.

Skills

Quality Assurance

Denial Management

Subject Matter Expert

Trend Analysis

Preventive Strategy

Continuous Learning

Production Support

Education

Bachelor’s or Master’s in Human Science / Anatomy background

B.Sc

M.Sc

B.Pharma

Job description

RCM Coding Specialist

Location: Hyderabad

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

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.

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 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.

Benefits

• Meals & Snacks: Enjoy 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, all at no cost to employees.
• Allowances: Annual wellness allowance to support your well‑being and productivity.
• Earned, casual, and sick leaves 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 even more memorable, and company‑paid holidays to recharge and unwind.

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