Coder - PAN India - SPE, SME, TL

Job highlights

• Required Skills Qualifications: . 2 to 8 years of hands-on experience in denial coding and multi-specialty coding
• Mandatory Certification: AAPC (e.g.,CPC,CPMA,CRC) or AHIMA (e.g.,CCS,RHIT) in Denial Coding
• Preferred (Not Mandatory): .
• Experience in denial analysis,appeals,and resolution strategies
• Experience in US healthcare revenue cycle management

We are seeking an experienced Denial Coding Specialist with a strong background in multi-specialty medical coding and denial management. The ideal candidate will have a comprehensive understanding of payer guidelines, coding principles, and denial resolution processes across multiple specialties. This role involves analyzing coding-related denials, identifying root causes, and implementing corrective actions to ensure accurate claim submission and reimbursement.

Key Responsibilities:

• Review and analyze claim denials related to coding issues across multi-specialty services.
• Apply correct ICD-10, CPT, and HCPCS codes in line with payer-specific and compliance guidelines.
• Identify trends in denials and provide feedback to internal coding teams or providers to reduce recurrence.
• Work closely with billing, coding, and revenue cycle teams to resolve complex coding denials.
• Appeal denied claims with accurate supporting documentation and coding rationale.
• Stay updated with latest payer policies, coding guidelines, and compliance requirements.
• Maintain documentation of denial reasons, actions taken, and resolution outcomes.

Required Skills Qualifications:

• 2 to 8 years of hands-on experience in denial coding and multi-specialty coding .
• Mandatory Certification: AAPC (e.g., CPC, CPMA, CRC) or AHIMA (e.g., CCS, RHIT) in Denial Coding.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, NCCI edits, and payer-specific rules.
• Experience in denial analysis, appeals, and resolution strategies.
• Familiarity with EMR/EHR systems and billing platforms.
• Strong analytical and problem-solving skills.
• Excellent written and verbal communication skills.

Preferred (Not Mandatory):

• Experience in US healthcare revenue cycle management.
• Prior exposure to specialties like radiology, cardiology, orthopedics, oncology, etc.
• Knowledge of Medicare, Medicaid, and commercial insurance guidelines.