RCM & Medical Coding Specialist

IT Resource Hunter; India; Remote; INR 600,000 - 1,200,000; Full time

Job summary

IT Resource Hunter is seeking a Senior RCM & Medical Coding Specialist for a fully remote role in India. The candidate should bring 4+ years of experience in Revenue Cycle Management and Medical Coding, with CPT, HCPCS, ICD-10-CM expertise and familiarity with AI-powered coding platforms.

You will support AI-enabled documentation, ensure accurate coding, and optimize reimbursement while maintaining compliance.

Qualifications

• Bachelor's degree in Healthcare Administration, Life Sciences, Nursing, or related field.
• Minimum 4+ years of experience in Medical Coding and Revenue Cycle Management.
• Strong knowledge of CPT, HCPCS, and ICD-10-CM guidelines.
• Experience with healthcare billing, claims adjudication, payment posting, denial management, and AR follow-up.
• Familiarity with AI-assisted clinical documentation or coding platforms.
• Experience reviewing SOAP notes and validating medical necessity.

Responsibilities

• Review and validate AI-generated SOAP notes, clinical documentation, and coding recommendations prior to claim submission.
• Assign and audit CPT, HCPCS, and ICD-10-CM codes based on provider documentation and coding guidelines.
• Ensure all medical records support billed services and comply with payer-specific policies and industry regulations.
• Manage end-to-end Revenue Cycle Management activities, including charge capture, claim submission, payment posting, denial management, and AR follow-up.
• Review coding outputs generated through AI-assisted documentation solutions and identify opportunities for correction or optimization.
• Collaborate with providers and clinical staff to resolve documentation deficiencies and coding discrepancies.
• Analyze denied and rejected claims, identify root causes, and implement corrective actions.
• Monitor coding accuracy, reimbursement trends, and revenue leakage opportunities.
• Support EHR-integrated workflows to ensure seamless movement of documentation from clinical encounters to billing processes.
• Conduct periodic coding audits and provide recommendations to improve compliance, coding quality, and revenue performance.
• Stay updated on changes in ICD-10-CM, CPT, HCPCS, CMS regulations, and payer guidelines.
• Assist in optimizing AI-assisted coding and documentation workflows to improve operational efficiency and claim acceptance rates.

Skills

Medical Coding

Revenue Cycle Management

CPT Coding

HCPCS Coding

ICD-10-CM Coding

EHR/EMR Systems

Denial Management

AR Follow-up

Analytical Skills

Communication Skills

Education

Bachelor's degree in healthcare

Tools

AI-powered coding tools

EMR/EHR software

Job description

Job Title:

RCM & Medical Coding Specialist

Duration:

Fulltime

Location:

100% Remote

Job Summary

We are seeking a highly skilled Senior RCM & Medical Coding Specialist with 4+ years of experience in Revenue Cycle Management and Medical Coding. The ideal candidate will possess strong expertise in CPT, HCPCS, and ICD-10-CM coding guidelines, healthcare billing operations, denial management, and claims processing. This role will support healthcare practices leveraging AI-powered clinical documentation and coding platforms to ensure accurate coding, billing-ready documentation, optimized reimbursement, and compliance with payer and regulatory requirements.

Key Responsibilities

• Review and validate AI-generated SOAP notes, clinical documentation, and coding recommendations prior to claim submission.
• Assign and audit accurate CPT, HCPCS, and ICD-10-CM codes based on provider documentation and coding guidelines.
• Ensure all medical records support billed services and comply with payer-specific policies and industry regulations.
• Manage end-to-end Revenue Cycle Management activities, including charge capture, claim submission, payment posting, denial management, and AR follow-up.
• Review coding outputs generated through AI-assisted documentation solutions and identify opportunities for correction or optimization.
• Collaborate with providers and clinical staff to resolve documentation deficiencies and coding discrepancies.
• Analyze denied and rejected claims, identify root causes, and implement corrective actions.
• Monitor coding accuracy, reimbursement trends, and revenue leakage opportunities.
• Support EHR-integrated workflows to ensure seamless movement of documentation from clinical encounters to billing processes.
• Conduct periodic coding audits and provide recommendations to improve compliance, coding quality, and revenue performance.
• Stay updated on changes in ICD-10-CM, CPT, HCPCS, CMS regulations, and payer guidelines.
• Assist in optimizing AI-assisted coding and documentation workflows to improve operational efficiency and claim acceptance rates.

Required Qualifications

• Bachelor's degree in Healthcare Administration, Life Sciences, Nursing, Medical Sciences, or a related field.
• Minimum 4+ years of experience in Medical Coding and Revenue Cycle Management.
• Strong knowledge of CPT, HCPCS, and ICD-10-CM coding guidelines.
• Experience in healthcare billing, claims adjudication, payment posting, denial management, and AR follow-up.
• Familiarity with AI-assisted clinical documentation, automated coding tools, or healthcare technology platforms.
• Experience reviewing SOAP notes and validating medical necessity for coded services.
• Strong understanding of E/M coding guidelines and documentation requirements.
• Knowledge of Medicare, Medicaid, and commercial payer policies.
• Experience working with EHR/EMR systems and healthcare practice management platforms.
• Excellent analytical, communication, and problem-solving skills.

Preferred Qualifications

• CPC, CCS, CCA, CRC, or equivalent certification.
• Experience working with AI-powered medical scribing or coding solutions.
• Knowledge of clinical documentation improvement (CDI) practices.
• Experience in provider education, coding audits, and compliance reviews.

Technical Skills

• Revenue Cycle Management (RCM)
• Medical Coding & Auditing
• CPT Coding
• HCPCS Coding
• ICD-10-CM Coding
• E/M Coding
• Denial Management
• Claims Processing
• Accounts Receivable Management
• Healthcare Compliance
• Clinical Documentation Review
• AI-Assisted Coding Validation
• EHR/EMR Systems
• Healthcare Analytics & Reporting