careers
senior-software-engineer
Location
Bangalore, India
Experience
5–8 years
Responsibilities:
- Review and analyze medical records, clinical documentation, and patient charts to assign accurate ICD-10-CM, CPT, and HCPCS codes.
- Ensure coding accuracy, completeness, and compliance with official coding guidelines and payer requirements.
- Validate documentation to support medical necessity, diagnosis, procedures, and level of service.
- Identify coding discrepancies, missing documentation, and potential compliance issues.
- Perform chart audits and quality checks to maintain high coding accuracy and minimize claim denials.
- Collaborate with physicians, clinical teams, billing teams, and RCM stakeholders to resolve coding and documentation queries.
- Stay updated on changes to ICD-10-CM, CPT, HCPCS, CMS regulations, NCCI edits, and other applicable coding guidelines.
- Support coding education and provide feedback on recurring documentation and coding issues.
- Work with AI-assisted coding and technology-enabled workflows to improve coding efficiency and accuracy.
- Maintain productivity and quality standards while meeting assigned turnaround times.
Technical Skills:
- Bachelor’s degree in Health Information Management, Medical Coding, Life Sciences, or a related field.
- 5–8 years of hands-on experience in professional or facility medical coding, preferably in the US healthcare domain.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- In-depth understanding of US healthcare revenue cycle management and clinical documentation.
- Strong knowledge of CMS guidelines, NCCI edits, medical necessity, and payer-specific coding requirements.
- Relevant certification such as CPC, CCS, CCA, or equivalent is preferred.
- Experience coding across multiple specialties is highly desirable.
- Strong understanding of E/M coding, modifiers, diagnosis sequencing, and procedure coding.
- Experience with chart auditing, coding quality assurance, and denial prevention.
- Ability to interpret complex clinical documentation and translate it into accurate medical codes.
- Strong analytical, critical-thinking, and problem-solving skills.
- Excellent attention to detail and ability to identify subtle coding and documentation discrepancies.
- Strong written and verbal communication skills.
- Ability to work effectively with physicians, coders, QA teams, and other healthcare stakeholders.
- Experience working with EHR, EMR, medical coding, and practice management systems.
- Familiarity with AI-assisted medical coding and automated coding validation platforms is a plus.
- Ability to work independently while meeting productivity, accuracy, and turnaround-time targets."
Eligibility: