Remote RCM Coding Specialist

Summary

Join Modernizing Medicine as a Medical Coding Auditor to contribute to the company's mission of making a positive impact on healthcare. As a key position in Modmed India Operations, you will be responsible for auditing work done by Global Partners and providing timely feedback to teams. You will also review and work on coding denials from payers, serve as a point of contact for coding questions and clarifications, and analyze coding denials to determine trends.

Requirements

• 5+ years of working experience in medical coding domain where minimum 2 years’ experience as SME/Quality in coding with Multi speciality experience
• Certification Mandatory - CPC
• Having strong knowledge in Gastro, Orthopaedics, Ophthalmology, Dermatology and Podiatry is preferred
• Hands on knowledge of Coding Denials on providing the resolution
• Good knowledge of Payer Guidelines to resolve the Denials related to Coding
• Good writing and Verbal communication in English
• Can work independently during the India Night Shift
• Can run reports and analyze the trends and scenarios. A strong hand in MS Excel will be a plus
• Expert in supplying/auditing/ analyzing the CPT, ICD Codes along with appropriate Modifiers
• CPC from AAPC or CCS from AHIMA
• Bachelors or Masters in Science with a background of Anatomy

Responsibilities

• Audit the work done by Global Partners and provide timely feedback to teams to aid in the quick resolution of denied coding claims
• Review & work on Coding denials from the Payers
• Serve as a point of contact as coding SME for coding questions and clarifications for the MMI team
• Review claims assigned to practices due to Coding issues in order to find out any trends and will work with CAs if practice education/ intervention is required
• Analyse coding denials to determine trends where preventive measures can be placed, such as scrub edits, provider training, action plans, coder training, etc

Benefits

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep
• Generous Paid Time Off and Paid Parental Leave programs
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters