Medical Coder

Work Mode: Office-based

Work Timings: Indian day shift and willingness to work an alternative schedule (i.e., outside the standard Monday–Friday routine)

Educational Qualification/Certification Required:
a. Preferred Bachelor’s degree in Life Sciences, Biotechnology, Pharmacy, Nursing, or a related field.
b. A valid certification in medical coding from AAPC or AHIMA (CPC/COC/CCS/CIC) is mandatory to apply for this position

Prior Experience/Skillsets required:
a. Valid and active CPC, COC, CCS or CIC certification from AAPC or AHIMA.
b. Sound knowledge of:

Roles and Responsibilities:
a. Ability to submit 100% of the processed charts directly to the client without requiring second-level support from the Quality Coach level.
b. You are expected to achieve a minimum of 95% accuracy in random pre- and post-delivery audits conducted.
c. Handle outpatient/inpatient charts, E&M coding, or specialty assignments as per project requirements.
d. Review medical records and assign accurate diagnosis and procedure codes.
e. Apply appropriate ICD-10-CM, CPT, HCPCS, and (if applicable) ICD- 10-PCS codes based on clinical documentation.
f. Validate MS-DRG/APR-DRG groupings for inpatient encounters.
g. Ensure adherence to official coding guidelines (AAPC/AHIMA), payer-specific rules, and NCCI edits.
h. Analyze documentation to determine the correct E&M level based on medical decision-making (MDM) components.
i. Maintain daily productivity targets, accuracy, and turnaround time (TAT) standards.
j. Ensure compliance with HIPAA, CMS, payer-specific guidelines, SOPs, and client-specific protocols.
k. Stay current with updates in CPT, ICD-10, HCPCS, and payer-specific guidelines.
l. Ability to work independently and as part of a team.
m. Collaborate with the Reporting Manager, Quality Coach, and QA for feedback and continuous improvement.
n. Attend internal training sessions to enhance specialty coding skills.
o. Contribute to audit readiness and actively participate in internal quality review processes.
p. Provide coding clarification and mentorship to junior coders.

Reporting Hierarchy: Reports to Associate Team Manager (ATM)/ Team Manager (TM)/ Senior Team Manager (STM)

Career Path: Medical Coder (MC) Senior Medical Coder (SMC) Executive Medical Coder(EMC) Quality Coach (QC)

Additional Perks:
a. Medical Insurance for self, spouse, and up to two dependent children under age 25
b. Accident insurance coverage equal to 5 x annual CTC of the employee
c. Complimentary canteen facilities (Bengaluru)
d. Certification Membership Reimbursement Policy: