Walk-in || Senior Medical Coder

Overview:

Advantmed India LLP is seeking a detail-oriented and knowledgeable Senior Medical Coders to join our team. Coders will be responsible for reviewing and accurately coding patient diagnoses, procedures, and treatments in accordance with established coding standards (ICD-10, CPT, HCPCS). The role requires a high level of attention to detail, strong knowledge of medical terminology, and the ability to ensure that coding practices meet regulatory and payer requirements.

Key Responsibilities:

1. Medical Coding:

• Review clinical documents, including medical records, physician notes, and diagnostic reports, to assign accurate ICD-10, CPT, and HCPCS codes for diagnoses, treatments, and procedures.
• Ensure accurate coding of all diagnoses, treatments, and procedures based on patient records to support billing and insurance claims.
• Work with physicians, clinical staff, and other healthcare professionals to resolve any discrepancies or ambiguities in the medical records for coding accuracy.
• Ensure all codes comply with the latest industry guidelines, payer requirements, and regulatory standards (e.g., HIPAA).

2. Compliance & Accuracy:

• Adhere to coding guidelines and ensure compliance with all relevant healthcare regulations and payer-specific requirements.
• Follow best practices for coding to minimize errors and ensure coding accuracy.
• Perform regular reviews of coding work to ensure that all records are coded accurately, completely, and in compliance with the highest quality standards.
• Maintain a deep understanding of industry changes, coding updates, and new regulations to ensure ongoing compliance.

3. Coding Audits & Quality Checks:

• Participate in internal coding audits to assess and improve coding accuracy.
• Correct any coding errors identified during audits and work with supervisors or team leads to implement corrective measures.
• Follow up on coding discrepancies, ensuring timely resolution and re-submission of corrected claims.

4. Collaboration & Communication:

• Collaborate with the Quality Assurance (QA) team, physicians, and clinical staff to clarify medical record documentation, and resolve any queries related to coding.
• Maintain communication with the billing department to ensure accurate claim submission and resolution of any issues with insurance payers.
• Address and respond to coding-related queries from team leads or management promptly.

5. Continuous Learning & Development:

• Stay up to date with new medical coding updates, industry standards, and regulatory changes to ensure the highest level of coding accuracy.
• Participate in ongoing training and certification programs to enhance knowledge and improve coding skills.
• Share knowledge and assist fellow coders with complex cases and coding challenges.

6. Documentation & Record Maintenance:

• Accurately document coding assignments, changes, and clarifications in medical records.
• Maintain organized records of coding and billing data in compliance with company standards and legal requirements.

7. Team Support:

• Collaborate with team members to ensure that all coding tasks are completed within the designated timelines and in line with quality standards.
• Assist in training new coders and sharing best practices to improve team efficiency and accuracy.

Qualifications:

• Education:
• Bachelor's degree in Life Sciences, Healthcare Administration, or a related field.
• Certification in Medical Coding (e.g., CPC, CCS, or equivalent) is required.
• Additional certifications in specialized coding areas (e.g., CPC-H, CPC-P) are an advantage.
• Experience:
• 2+ years of experience in HCC medical coding
• Knowledge of medical coding systems (ICD-10, CPT, HCPCS).
• Familiarity with medical terminology, anatomy, and physiology.
• Skills:
• Strong attention to detail, with the ability to review complex medical documentation and accurately assign codes.
• Excellent knowledge of coding practices, standards, and payer requirements.
• Proficiency in coding software and tools, as well as MS Office (Excel, Word).
• Strong communication skills to interact with physicians, clinical staff, and other team members.
• Ability to handle high volumes of work and meet deadlines in a fast-paced environment.

Personal Attributes:

• High level of integrity and commitment to maintaining confidentiality.
• Strong organizational and time-management skills.
• Ability to work independently and as part of a team.
• Proactive problem-solving attitude with attention to detail.
• Continuous learner, staying updated on industry changes and best practices.