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Medical Coder – Profee Multispecialty Denial

Guidehouse
Guidehouse
1-2 years
preferred by company
PAN-India, India
1 May 13, 2026
Job Description
Job Type: Full Time Education: B.Sc/M.Sc/M.Pharma/B.Pharma/Life Sciences Skills: Data Analysis, Document Management, Life Science, Regulatory Compliance, Waterfall Model, Environment, Experiments Design, Health And Safety (Ehs), Laboratory Equipment, Manufacturing Process, Materials Science, Process Simulation, Sop (Standard Operating Procedure), Technical Writing, Wat, GCP guidelines, gmp knowledge, HSE Knowledge , Logistics and Transportation Management, Master Data, Operational Excellence, Sap Erp, supply chain management, Supply Planning, Warehouse Management, ICD-10 CM Codes, CPT-Codes, HCPCS Codes

Job Title: Medical Coder – Profee Multispecialty Denial

Location: India
Job Type: Full-Time
Experience Required: 1–2 Years (Freshers are not eligible)
Industry: Healthcare / Medical Coding / Revenue Cycle Management / Healthcare BPO / Medical Billing
Department: Medical Coding Operations / Denial Coding / Professional Fee Coding

About the Role
We are hiring a detail-oriented Medical Coder – Profee Multispecialty Denial to support denial coding review, professional fee coding, medical documentation analysis, reimbursement optimization, and coding compliance within healthcare revenue cycle operations. This role is ideal for professionals with expertise in ICD-10-CM coding, CPT coding, HCPCS coding, denial management, Profee coding, emergency department coding, and multispecialty medical coding.

The ideal candidate will review denied healthcare claims, accurately assign or validate diagnosis and procedure codes, support denial resolution workflows, maintain productivity targets, and ensure compliance with healthcare coding standards and client requirements.

This opportunity is highly suited for early-career medical coding professionals looking to specialize in denial coding and revenue cycle healthcare operations.

Key Responsibilities

Professional Fee Medical Coding (Profee)

  • Accurately convert patient diagnoses, procedures, and healthcare services into standardized medical alphanumeric codes using:
    • ICD-10-CM
    • CPT coding standards
    • HCPCS coding systems
  • Ensure coding accuracy aligns with payer reimbursement guidelines, client workflows, and coding compliance requirements.

Multispecialty Denial Coding Review

  • Review denied healthcare claims and medical records to identify coding corrections, documentation gaps, and reimbursement improvement opportunities.
  • Support denial resolution workflows through accurate coding review and claim analysis.
  • Apply coding expertise to improve claim acceptance and reimbursement outcomes.

Medical Records Interpretation

  • Interpret patient clinical documentation, physician notes, diagnostic information, and procedural records across multiple specialties.
  • Analyze healthcare documentation for coding completeness, clarity, and compliance.
  • Ensure proper code assignment based on medical record content and client coding rules.

Emergency Department & Specialty Coding Support

  • Apply coding expertise across specialties including:
    • Emergency Department (ED) coding
    • Multispecialty denial workflows
    • Radiology coding exposure
    • E&M and related healthcare coding processes
  • Support accurate coding across diverse healthcare documentation scenarios.

Coding Productivity & Turnaround Management

  • Complete assigned coding volumes accurately within specified turnaround time (TAT) expectations.
  • Track workload assigned by Team Leads (TLs) and ensure timely delivery.
  • Maintain operational productivity standards while preserving coding quality.

Quality & Accuracy Compliance

  • Consistently achieve 95%+ coding accuracy while meeting monthly productivity goals.
  • Follow internal coding SOPs, payer guidelines, and client-specific coding instructions.
  • Support coding quality excellence and audit readiness.

Team Collaboration & Performance Communication

  • Work effectively both independently and within coding teams.
  • Collaborate regularly with Team Leads and Quality Analysts for feedback, coaching, and performance improvement.
  • Participate actively in team-based operational workflows.

QA Meetings & Continuous Learning

  • Attend weekly QA meetings and team review sessions without fail.
  • Engage in two-way communication regarding coding performance, audit findings, and operational expectations.
  • Apply continuous improvement practices based on quality feedback.

Workflow & Client Process Compliance

  • Develop strong understanding of assigned client workflows, denial management processes, coding rules, and operational requirements.
  • Maintain compliance with healthcare reimbursement and coding governance standards.

Information Security & Data Compliance

  • Follow organizational information security policies to protect healthcare information confidentiality, integrity, and availability.
  • Report data security incidents or compliance concerns according to policy.

Required Qualifications

  • Graduation or post-graduation in:
    • Life Sciences
    • Paramedical Sciences
    • Allied Healthcare disciplines
    • Related healthcare educational backgrounds
  • Minimum 1–2 years of medical coding experience
  • Freshers are not eligible