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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, ICD-10 CM, CPT, HCPCS Coding

Job Title: Medical Coder – Profee Multispecialty Denial

Location: India
Job Type: Full-Time
Experience Required: 1–2 Years
Industry: Healthcare / Medical Coding / Revenue Cycle Management / Medical Billing / Healthcare Operations
Department: Professional Fee Coding / Denial Management / Medical Coding Operations

About the Role

We are hiring a Medical Coder – Profee Multispecialty Denial to support healthcare coding operations focused on denial management, professional fee coding, and multispecialty medical documentation review. This role is ideal for candidates with hands-on experience in ICD-10-CM, CPT, HCPCS, denial coding, emergency department coding, and healthcare reimbursement workflows.

The role involves reviewing denied claims, interpreting patient documentation, assigning accurate diagnosis and procedure codes, and supporting reimbursement optimization while maintaining strong coding productivity and quality standards.

Key Responsibilities

Medical Coding & Code Assignment

  • Accurately assign standardized medical codes using:
    • ICD-10-CM
    • CPT
    • HCPCS
  • Convert diagnoses, procedures, and healthcare services into accurate alphanumeric billing codes.
  • Ensure coding aligns with coding guidelines and client-specific requirements.

Denial Coding & Claims Review

  • Review denied claims and identify coding-related causes impacting reimbursement.
  • Support denial correction workflows through accurate code validation and reassessment.
  • Work on denial-related coding cases to improve payment outcomes.

Multispecialty Documentation Review

  • Interpret medical records across multiple specialties.
  • Review physician documentation, clinical summaries, and procedure notes.
  • Ensure accurate coding for varied healthcare documentation types.

Emergency Department / Specialty Exposure

  • Apply coding knowledge in:
    • Emergency Department coding
    • Radiology exposure
    • Multispecialty denial workflows
    • Professional fee coding

Productivity & Turnaround Time

  • Complete assigned daily coding volumes within required turnaround time.
  • Monitor workloads assigned by Team Lead.
  • Balance speed, productivity, and coding accuracy effectively.

Quality & Compliance

  • Maintain 95%+ coding accuracy consistently.
  • Follow client coding workflows, QA standards, and internal coding policies.
  • Ensure operational quality and audit readiness.

Team Collaboration

  • Work independently and collaboratively with coding teams.
  • Regularly interact with Team Leads and Quality Analysts.
  • Participate in weekly QA and operational meetings.

Information Security

  • Follow organizational information security and confidentiality policies.
  • Protect healthcare data and report security incidents if required.

Required Qualifications

  • Life Sciences / Paramedical Graduate or Postgraduate
  • 1–2 years of medical coding experience

Required Skills

  • Strong expertise in:
    • ICD-10-CM coding
    • CPT coding
    • HCPCS coding
    • Professional Fee (Profee) coding
    • Denial coding
    • Medical records interpretation
  • Exposure to:
    • Emergency room coding
    • Radiology coding
    • Multispecialty coding workflows
  • Strong analytical and documentation review skills
  • Excellent communication and interpersonal skills
  • High speed with strong accuracy focus

Preferred Skills

  • MS Office / Excel
  • Coding tools / encoders:
    • 3M
    • TruCode
    • Optum
  • EHR / EMR systems:
    • EPIC
    • Cerner
  • Additional coding exposure:
    • E&M coding (OP/IP)
    • ED coding
    • Multispecialty workflows