Medical Coding SME - Remote Position

R Systems; United States; On-site; USD 100,000 - 140,000; Full time

Job summary

R Systems is seeking a Medical Coding Expert to work on autonomous AI-assisted coding platforms across complex clinical scenarios, including Surgery, Anesthesia, Orthopedics, and Inpatient coding. You will review documentation, ensure compliance, and independently assign accurate codes with an eye for gaps and improvements.

Ideal candidates bring deep ICD-10-CM/PCS, CPT/HCPCS, DRG knowledge and hands-on experience with AI-enabled coding tools, testing and validating AI recommendations, and

Qualifications

• Deep knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRG and modifiers.
• Ability to review clinical documentation and assign correct codes independently.
• Experience with autonomous/AI-assisted medical coding platforms and evaluating AI-generated recommendations.
• Ability to identify gaps, missing information, and opportunities to improve coding accuracy.

Responsibilities

• Test, validate, and provide feedback on autonomous coding solutions (e.g., AI-driven platforms).
• Review complex clinical documentation across Surgery, Anesthesia, Orthopedics, and Inpatient coding scenarios.
• Ensure coding compliance and documentation guidelines are met across codes and procedures.

Skills

Medical coding

Independent coding

AI-assisted coding evaluation

Clinical documentation review

Tools

Autonomous coding platforms

AI-assisted coding tools

Job description

R Systems is a leading digital product engineering company that designs and develops chip-to-cloud software products, platforms, and digital experiences that empower its clients to achieve higher revenues and operational efficiency. Our product mindset and engineering capabilities in Cloud, Data, AI, and CX enable us to serve key players in the high-tech industry, including ISVs, SaaS, and Internet companies, as well as product companies in telecom, media, finance, manufacturing, and health verticals.

We Are Great Place to Work® Certified™ in 10 countries with a full-time workforce [India, USA, Canada, Poland, Romania, Moldova, Indonesia, Singapore, Malaysia & Thailand]!

We are recognized as one of the Best Tech Brands 2024 by theTimes Group and India's Top 500 Value Creators 2023 by Dun & Bradstreet.

Company Link: R Systems | Digital Product Engineering

Job Description

Required Skills:

Medical Coding & Autonomous Coding Expert

• Seeking experienced Medical Coding SMEs/Experts with strong hands-on expertise in Surgery, Anesthesia, Orthopedics, and Inpatient coding across complex clinical scenarios.
• Must have deep knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, DRG, modifiers, documentation guidelines, and coding compliance.
• Experience with autonomous/AI-assisted medical coding platforms and ability to evaluate coding recommendations generated from clinical charts, physician documentation, procedures, prescriptions, and patient information.
• Ability to review clinical documentation and determine the correct medical codes independently, while identifying missing information, coding gaps, inaccurate AI recommendations, and opportunities for coding improvement.
• Looking for experts who can help test, validate, and provide feedback on autonomous coding solutions, particularly solutions similar to Fathom, CodaMetrix, Nym, and other AI-driven medical coding platforms.

Why Join R Systems?

Frequent Internal Hackathons: Engage in dynamic competitions with exciting prizes to keep your skills sharp.

Cultural Celebrations: Strengthen our familial bonds through shared celebrations, fostering a sense of community.

Diverse Project Exposure: Work on a variety of projects across sectors like Healthcare, Banking, e-commerce, and Retail, collaborating with leading global brands.

Centre of Excellence (COE): Benefit from technical guidance and upskilling opportunities provided by our team of technology experts, helping you navigate your career path.

E-Learning Platform: Gain access to comprehensive e-learning platforms coupled with a robust mentorship program to enhance your skills.

Open Door Policy: Embrace a culture of mutual support, respect, and open dialogue, promoting a collaborative work environment.

R Systems is an equal opportunity employer that does not discriminate against any employee or job applicant because of race, color, religion, national origin, sex, physical or mental disability, age, or any other characteristic protected by law. We strive to build a team that reflects the diverse communities we serve, and we actively encourage applications from individuals of all backgrounds and experiences. Our commitment to equal opportunity extends to all aspects of employment, including recruitment, hiring, training, promotion, and benefits.