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    Senior Medical Coder

    Optum
    3+ years
    Not Disclosed
    Bangalore
    10 March 9, 2025
    Job Description
    Job Type: Full Time Education: B.Sc./M.Sc./B.Pharm/M.Pharm/Life science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

    Job Title: Senior Medical Coder

    Location: Bangalore, Karnataka, India

    Role Overview:

    As a Senior Medical Coder, you will play a crucial role in assigning accurate medical codes based on clinical documentation, ensuring compliance with coding guidelines and regulations. You will work independently, solve complex coding issues, and support quality audits while mentoring junior coders.

    Key Responsibilities:

    • Medical Coding & Compliance:

      • Extract relevant details from clinical documentation and assign appropriate medical codes.
      • Utilize coding software, reference materials, and guidelines to ensure accuracy.
      • Apply National Correct Coding Edits (NCCI), Local & National Coverage Determinations in coding decisions.
      • Resolve coding edits and denials related to code assignments.
      • Maintain productivity and turnaround time standards for medical record reviews.
      • Ensure compliance with federal, state, and professional guidelines.

    • Problem-Solving & Audit Support:

      • Identify and address non-standard coding issues proactively.
      • Conduct medical coding audits to ensure quality and compliance.
      • Review audit results, provide feedback, and resolve discrepancies.
      • Support quality audits by responding to coding queries.

    • Mentoring & Documentation Review:

      • Identify unclear or incomplete documentation and generate queries for additional information.
      • Follow up with providers when queries are not answered in a timely manner.
      • Mentor and educate team members to improve coding accuracy and efficiency.

    • Software Utilization & Reporting:

      • Leverage clinical software applications for coding and review processes.
      • Utilize tools like Microsoft Office to record information and analyze data.
      • Comply with company policies, employment contract terms, and procedural directives.

    Required Qualifications:

    • Bachelor’s or Master’s degree in Life Sciences.
    • CPC certification (AAPC) or AHIMA certification.
    • 3+ years of experience in HCC Medical Coding.

    Preferred Qualification:

    • Experience in CPT coding.

    Industry: Healthcare

    Opportunity Type: Regular

     

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