RCM Coding Specialist
HyderabadFull-time5–9 yrsPosted over a month ago
Senior software engineering role at ModMed Technologies in Hyderabad. Needs 5+ years and a B.Sc, M.Sc or B.Pharm.
About the role
The RCM Coding Specialist is a vital new role designed to make our team self-sufficient across the entire Revenue Cycle Management (RCM) cycle. This position serves as a Subject Matter Expert (SME), ensuring that medical coding is accurate, compliant, and optimized to reduce denials. You will bridge the gap between our global partners and US-based teams, providing the technical expertise necessary to improve patient outcomes and practice success.
What you'll do
- Quality Assurance & Auditing (25%): Audit coding performed by Global Partners and provide timely feedback to resolve denied claims quickly
- Denial Management (20%): Review and resolve coding denials from payers, ensuring accurate resubmission and revenue recovery
- Subject Matter Expertise (20%): Act as the primary point of contact for coding questions and clarifications for the MMI team
- Trend Analysis (15%): Review claims assigned to practices due to coding issues to identify trends
- Preventive Strategy (10%): Analyze denial data to recommend preventive measures, such as scrub edits, provider training, and internal action plans
What you need
- Medical coding