162 Hcpcs Jobs - Page 6

Oversee and manage client medical and routine vision claims, ensuring compliance with CMS standards and optical billing regulations. Ensure timely and accurate processing of all client claims. Utilize the correct coding (e.g., ICD-10, CPT, HCPCS) to facilitate appropriate reimbursement. Collaborate with clients to resolve complex billing issues and discrepancies. Review insurance EOBs and work with clients to address claim denials or underpayments. Work closely with clients to educate and guide them on best billing practices for Optometry and Ophthalmology claims. Monitor the claims lifecycle, from submission to resolution, ensuring timely reimbursement for services rendered Qualifications : Strong knowledge of CPT, ICD-10, and HCPCS codes as they relate to Optometry, Ophthalmology, and routine vision services. Familiarity with Vision Plan Claims filing and optical-related billing. Ability to interpret and apply insurance company Explanation of Benefits (EOBs) effectively. Detail-oriented, analytical, and highly organized, with the ability to manage multiple priorities. Problem-solving skills to identify, research, and resolve billing issues independently. Strong written and verbal communication skills, with a focus on providing excellent customer service. Ability to quickly adapt to new software programs and systems. Excellent interpersonal skills and the ability to build strong relationships with clients. Oversee and manage client medical and routine vision claims, ensuring compliance with CMS standards and optical billing regulations. Ensure timely and accurate processing of all client claims. Utilize the correct coding (e.g., ICD-10, CPT, HCPCS) to facilitate appropriate reimbursement. Collaborate with clients to resolve complex billing issues and discrepancies. Review insurance EOBs and work with clients to address claim denials or underpayments. Work closely with clients to educate and guide them on best billing practices for Optometry and Ophthalmology claims. Monitor the claims lifecycle, from submission to resolution, ensuring timely reimbursement for services rendered Qualifications : Strong knowledge of CPT, ICD-10, and HCPCS codes as they relate to Optometry, Ophthalmology, and routine vision services. Familiarity with Vision Plan Claims filing and optical-related billing. Ability to interpret and apply insurance company Explanation of Benefits (EOBs) effectively. Detail-oriented, analytical, and highly organized, with the ability to manage multiple priorities. Problem-solving skills to identify, research, and resolve billing issues independently. Strong written and verbal communication skills, with a focus on providing excellent customer service. Ability to quickly adapt to new software programs and systems. Excellent interpersonal skills and the ability to build strong relationships with clients.

Audit on coded medical records for Surgery & Evaluation, Management (E&M) (IP & OP) Ensure compliance with ICD-10, CPT, HCPCS, payer-specific Identify, rectify coding errors, ensuring accuracy, completeness Collaborate with coders, physicians Required Candidate profile Stay updated on industry regulations and coding updates. Maintain quality benchmarks and coding standards. Generate audit reports and provide feedback for process improvement. Free Recruitment Perks and benefits Perks and Benefits

Dear All, Greetings from Flatworld Healthcare Services. WE ARE HIRING !! Hiring: Spravato/Mental Health Biller & Caller Location: Bangalore (In-office) Experience: 1-2 years Company: Finnastra Client: Flatworld Healthcare Solutions We are looking for a Spravato/Mental Health Biller & Caller with 1-2 years of experience in US healthcare RCM. The role involves billing, claims processing, denial management, and AR follow-ups for Spravato (Esketamine) & Mental Health services . Strong communication skills are required to interact with insurance companies, providers, and patients for timely reimbursement. Key Responsibilities: Process & submit Spravato/Mental Health claims Verify insurance eligibility & obtain prior authorizations Follow up on denied/rejected claims & resolve outstanding AR Ensure compliance with payer policies & HIPAA Skills Required: Experience in medical billing & coding (CPT, HCPCS, ICD-10) Strong knowledge of denial management & claim follow-up Familiarity with insurance portals, EHRs & clearinghouses Excellent communication & analytical skills Why Join Us? Competitive salary & incentives Work with global clients Growth opportunities in US healthcare RCM Interested candidates can share their CVs at pavan.v@finnastra.com or contact 9035473861 (Available between 11 AM - 9 PM ).

Role & responsibilities Post payments and adjustments to patient accounts from various payers, including insurance companies, Medicare, Medicaid, and patient payments. Review and process remittance advice (ERA) and explanation of benefits (EOB) to ensure accurate payment posting. Ensure accurate coding and compliance with payer-specific requirements during payment posting. Reconcile and resolve payment discrepancies, ensuring that payments are applied correctly. Work closely with the billing and coding team to resolve denials, payment errors, and outstanding balances. Identify and report any trends or issues with payment posting, including incorrect payments or denied claims. Process overpayments, refunds, and adjustments according to company policies and procedures. Assist in monthly and quarterly reporting on payment posting activities and outstanding balances. Maintain clear and accurate documentation of all payment transactions and related communications. Provide support in managing and maintaining accounts receivable balances. Stay updated with payer changes, government regulations, and insurance guidelines. Perform other duties as assigned by management to support the overall revenue cycle process. Apply manual payments and auto payments to accounts for payor types of Medicare, Medicaid and Commercial Insurances; Qualifications: High school diploma or equivalent (Associates or Bachelors degree in healthcare, business, or related field is a plus). years of experience in payment posting within healthcare or revenue cycle management. Strong understanding of healthcare insurance, payers, and remittance advice. Proficient in using payment posting software and electronic health record (EHR) systems. Detail-oriented with excellent organizational and problem-solving skills. Strong communication skills and ability to work collaboratively with cross-functional teams. Knowledge of HIPAA regulations and confidentiality guidelines. Ability to work independently and meet deadlines in a fast-paced environment. Preferred Qualifications: Knowledge of medical billing codes (CPT, ICD-10, HCPCS). Prior experience in healthcare physician billing. Working Conditions: Work in an office setting with a focus on data entry and systems management. Plus point if know the workaround Greenway Integrity Software. Perks and benefits

Medical Coding is the process of converting Verbal Descriptions into numeric or alpha numeric by using ICD 10-CM, CPT && HCPCS. As per HIPAA rules healthcare providers need efficient Medical Coders. Qualification & Specifications : MBBS,BDS,BHMS,BAMS,BSMS,PHARMACYB.Sc/M.Sc (Life Sciences / Biology / Bio Chemistry / Micro Biology / Nursing / Bio Technology), B.P.T, B.E BIOMEDIAL, B.Tech (Biotechnology/Bio Chemistry). 2020 -2024 passed out Skills Required: * Candidates should have Good Communication & Analytical Skills and should be Good at Medical Terminology (Physiology & Anatomy). Role: To review US medical records Initial file review for identifying merits Subjective review and analysis to identify instances of negligence, factors contributing to it To review surgical procedures, pre and post-surgical care, nursing home negligence To prepare medical submissions To prepare the medical malpractice case Regards Soniya 72000 52460

Medical Coding is the process of converting Verbal Descriptions into numeric or alpha numeric by using ICD 10-CM, CPT && HCPCS. As per HIPAA rules healthcare providers need efficient Medical Coders. Qualification & Specifications : MBBS,BDS,BHMS,BAMS,BSMS,PHARMACYB.Sc/M.Sc (Life Sciences / Biology / Bio Chemistry / Micro Biology / Nursing / Bio Technology), B.P.T, B.E BIOMEDIAL, B.Tech (Biotechnology/Bio Chemistry). 2018 -2024 passed out Skills Required: * Candidates should have Good Communication & Analytical Skills and should be Good at Medical Terminology (Physiology & Anatomy). Role: To review US medical records Initial file review for identifying merits Subjective review and analysis to identify instances of negligence, factors contributing to it To review surgical procedures, pre and post-surgical care, nursing home negligence To prepare medical submissions To prepare the medical malpractice case Regards Kowshika +91 7200652461

Job Title : Associate/ Sr. Associate- Medical Coder Location: Pune/Mumbai/Nagpur (Work from Office) (Address details mentioned below) Company Profile: First Insight is a product based software development company based in Portland, Oregon (USA). Our expertise and domain lies in 'Health care' and 'Insurance'. We are a forward thinking, visionary company that provides high-quality software solutions, support, and training to nearly 1,000 ophthalmic practices in the U.S. and Canada. We have carved a niche in the health care industry with our high quality products: e-commerce solutions, practice management software and electronic medical records that are revolutionizing the field of eye care. To know more about us please visit us @ www.first-insight.com Our major software development and technical support happens from the Pune office. To meet our rapidly expanding business growth we need talented assets. 'You donate us your talent and we'll nurture a fine future for you'; that's the FIC principle. We are hiring Medical Coders for our facility in Pune. The details are as under: Job Description: Analytical coding skills to provide appropriate CPT, ICD 10 CM and HCPCS codes according to medical documentation. Should have good knowledge in Anatomy, Physiology and Terminology Strong in medical coding background in coding multi-specialty coding such as E/M, Surgery, radiology,ED,outpatient and inpatient coding. Optometry/ophthalmology coding experience preferred. To demonstrate Knowledge of LCD, NCD Guidelines, NCCI edit required To demonstrate Knowledge of Medicare, Medicaid guidelines as well commercial payer guidelines . To demonstrate Knowledge of Denial management of multispecialty and review coding denials of multispecialty provide concrete resolutions to coding denials. To demonstrate knowledge around revenue cycle management. Auditing the coding line items before submitting claims to insurance. To demonstrate expertise on E/M & EYE codes along with surgery guidelines with latest updates and trends and excellent skills in medical terminologies, anatomy , physiology, CPT, HCPCS, ICDs and modifiers HCC coders and Home Health Coders no need to apply . Desired Candidate Profile: Life Science Graduate ,B. Pharm, BAMS, BHMS, Bioinformatics with medical coding experience required. Certified Professional Coder (CPC) from the American Academy of Professional Coders: (AAPC), with knowledge of HCPCS, ICD, CPT, Optometry/ophthalmology coding preferred. Skills required: Ability to multi-task. Good organization skills demonstrating the ability to execute timely follow-up . Willingness to be a team player and show initiative where needed. Experience in Medical Coding for more than 2 years. Excellent Oral and Written Communication skills . Salary: Remuneration will be at par with the best industry standards; will not be a constraint for the right candidate. Interested Candidate can also share their resumes directly to the recruiters below: Rohit Ghate - 7888025217 rohitghate@first-insight.com Address details: Registered Office Address- Pune: First Insight Software Solutions (I) Pvt. Ltd., 2nd Floor, Server Space, AG Technology Park, Off ITI Road, S. No.127/1A, Plot No.8, Aundh, Pune 411 007 Mumbai: Unit No. 302, 3rd Floor, New Technocity, Plot No. X-4/5A, TTC Industrial Area, Mahape MIDC, Navi Mumbai - 400 710 Nagpur: Unit No. 201, 2nd Floor, Wing - C, VIPL IT Park, Plot No. 28, MIDC IT Park, Gayatri Nagar Road, Parsodi, Nagpur - 440 022

We are seeking a dedicated and detail-oriented Medical Health Claim Form Analyst to join our team. This remote position is responsible for managing and processing medical claims, ensuring that data is accurately captured from various healthcare forms such as HCFA (CMS 1500), UB04, and Dental Claim Forms (ADA). The role will evolve to encompass broader responsibilities, including claims processing, prior authorizations, medical records management, and revenue cycle management across multiple phases. Key Responsibilities: Data Capturing from Healthcare Documents: Accurately capture data from HCFA (CMS 1500) forms for healthcare claims related to physician services. Process and verify data from UB04 (Uniform Billing) forms for institutional claims such as hospital or facility billing. Review and enter Dental Claims (ADA), ensuring correct data entry from dental service claims. Claims Processing Editing: Review claims submitted by healthcare providers for completeness, accuracy, and compliance with payer requirements. Edit and modify claims based on payer guidelines to ensure timely and accurate claim submissions. Prior Authorization: Coordinate with healthcare providers to obtain prior authorization for specific medical services and procedures, ensuring proper approval before services are rendered. Enrollment Processing: Manage the enrollment process for members, ensuring accurate information and seamless integration into the system. Payment Integrity: Conduct audits to verify the accuracy of claim payments, identifying discrepancies and implementing corrective actions. Revenue Cycle Management (RCM): Oversee the full revenue cycle process, from claim submission to payment, ensuring accuracy and completeness at every step. Revenue Integrity: Monitor claims to ensure compliance with healthcare regulations and payer policies, ensuring that all charges are accurately captured and billed. Denials Management: Investigate and resolve denied claims, identifying root causes and working to prevent future denials. Claim Submission Editing: Submit corrected claims and follow up with the payer to ensure timely processing. Medical Records Management: Ensure that medical records are complete, accurate, and compliant with regulatory requirements. Perform eligibility verification for patients to confirm coverage and benefits. Medical Records Coding: Assign appropriate codes (ICD-10, CPT, HCPCS) to medical diagnoses and procedures to ensure accurate billing and reimbursement. Patient Demographics Registration: Ensure patient demographic information is accurately recorded and updated in the system. Pre-certification: Verify and manage pre-certification requests to ensure medical procedures or services are authorized by insurance companies. Accounts Receivable: Manage and follow up on outstanding balances, ensuring timely collection of payment. Charge Entry / Charge Posting: Enter charges for services rendered into the system and ensure accurate posting. Medical Logs Indexing: Organize and index medical logs for easy access and retrieval when needed. Physician Hospital Billing: Handle billing processes related to physician services and hospital services. Appeals: Respond to and manage appeals for claims that have been denied or underpaid. Qualifications: Education: Bachelor s degree in Health Administration, Business, or related field (preferred). Certification in Medical Billing or Coding (e.g., CPC, CCS) is a plus. Experience: Minimum 1-2 years of experience in medical claims processing, healthcare billing, or revenue cycle management. Familiarity with HCFA (CMS 1500), UB04, and Dental Claim (ADA) forms is highly preferred. Experience in working with medical codes (ICD-10, CPT, HCPCS) is beneficial. Skills: Strong attention to detail and accuracy. Proficiency in healthcare software, billing systems, and databases. Knowledge of payer policies, coding systems, and regulations. Excellent communication skills and the ability to work independently. Strong analytical skills and problem-solving abilities. Ability to manage multiple tasks and meet deadlines. Benefits: Health insurance, paid time off, 401(k), and other company benefits Overview Experience 1-2 Qualification Bachelor s degree in Health Administration, Business, or related field (preferred),Certification in Medical Billing or Coding (e.g., CPC, CCS) is a plus

Work Location : Bengaluru and Ahmadabad Shift Timings : 2PM to 11PM and 6PM to 3AM NP : Immediate to 30 Days Skill Set required : Coding Certifications; (CPC and/or CCS). - 3 Years of relevant experience in Hospital inpatient coding for a variety of medical specialties and diagnosesis must - Having hands on experience in Facility coding and Denial Process. - Medical Coding Proficiency: Proficient in assigning ICD-10-CM, ICD-10-PCS, and CPT codes to varied inpatient medical cases. - Strong knowledge in Inpatient DRG Facility Coding and appeal processes for inpatient denial. - Strong knowledge in assigning MS-DRGs and APR-DRGs for accurate reimbursement and statistical reporting. - HCPCS/CPT codes (Level I and II) - Correctly and compliantly append modifiers. - Experience in coding multiple outpatient services: Emergency Department, Observation Services, Same Day Surgery, Ancillary Diagnostic and Therapeutic Services, PT/OT/SLP, etc. - Strong injection and infusion coding skills. - Compliant query writing utilizing the AHIMA/ACIDS published 2022 guidelines. - Strong awareness of HIPAA compliance

Key Skills: Strong knowledge of medical terminology, coding (CPT, ICD-10), and billing practices. Proficient in Microsoft Office Suite and healthcare billing software. Excellent attention to detail and strong organizational skills. Required Candidate profile Preferred Candidate Profile: Graduate in any stream is mandatory. Should have proficiency in Typing (25 WPM with 95% of accuracy) Should be flexible with 24*7 shift.

About the role Review patient medical records following PHI, HIPPA and convert into medical coding code as per ICD-10-CM and PCS guidelines. Complete daily assign tasks within time with expected quality, on time communication to internal/external stakeholders and adhere to organization policies. We are looking to hire an experienced Medical Coders / Senior Medical Coders with coding certifications (CIC or CCS) hands on experience on Inpatient DRG (MS-DRG/APR-DRG) coding. Eligibility Criteria 1 to 7+ Years of work experience in IP DRG medical Coding Education Any Graduate, Postgraduate Successful completion of a certification program from AHIMA (CCS) or AAPC (CIC) Must be active during joining and verified. Strong knowledge of anatomy, physiology, and medical terminology Effective verbal and written communication skills (should have capability to reply to email properly to client and stakeholders) Able to work independently and willing to adapt and change as per business/process requirement. Responsibilities Reviewed inpatient medical records and assigned accurate ICD-10-CM (PDx and SDx) and PCS codes for diagnoses and procedures. Assigned and sequenced codes accurately based on medical record documentation. Assigned POA indicators correctly. Thorough understanding and application of medical necessity, DRGs, APGs, and APRs for processing claims Adhered to coding clinics and guidelines, and queried physicians for clarification as needed. Checking on the account status on regular basis if kept on Hold and follow up with respective leaders when in needed. Knowledge of 3M coding, Optum, computer assisted coding (CAC), abstracting software, Meditech etc. will be added advantage. Interested candidate please share their resume @ dbisht4@r1rcm.com.

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: https: / / www.solventum.com / en-us / home / legal / website-privacy-statement / applicant-privacy / continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Nosology Analyst (Solventum) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You ll Make in this Role As a Nosology Services Analyst / Hospital Outpatient Coder, you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. This position is for a highly experienced and motivated facility medical coding specialist. Here, you will make an impact by: Applying advanced knowledge of outpatient facility coding including grouping/editing guidelines and the ability to research complex issues as well as regulatory guidelines and changes. Responding to inbound customer support requests for medical/surgical coding, editing and grouping problem resolution which will require extensive research. Providing customers with professionally written responses which include rationale and education. Utilizing ability to troubleshoot customer inquiries regarding 3M Coding and Reimbursement system. Building credibility and trust with 3M HIS customers and department by providing solutions to software issues, inquiries, and problems Your Skills and Expertise To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: Associates degree or higher (completed and verified prior to start) and five (5) years experience as a coding professional. OR High School Diploma/GED (completed and verified prior to start) and seven (7) years of experience as a coding professional AND In addition to the above requirements, the following are also required: RHIA, RHIT, or CCS certification Additional qualifications that could help you succeed even further in this role include: Expert knowledge of current published coding guidance such as CPT Assistant, ICD-10-CM Official Guidelines and the American Hospital Associations (AHA) Coding Clinic and Coding Clinic for HCPCS Expertise in working with the APC Grouper and NCCI system Expertise in navigating the CMS website to research guidelines. Experience utilizing Solventum Coding Reimbursement System Excellent written and verbal communication skills. Understanding of health care industry. Proven analytical and problem-solving skills. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com . Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here , select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.

Who we are: R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industrys most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where were all together better. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, amongst Top 50 Best Workplaces for Millennials, Top 50 for Women, Top 25 for Diversity and Inclusion and Top 10 for Health and Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30, 000 employees globally, we are about 17, 000+ strong in India with presence in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. About the role As the Associate Operations Manager, your primary role will be primarily responsible for driving a high-morale team, a culture of high performance, meeting client deliverables consistently, and effectively managing stakeholders. Eligibility Criteria 10 Years of total work experience in Medical Coding, with 3-5 years of team management experience. Must have > 3 years of coding experience in the Same day Surgery, E&M, ED Facility & Observation Working knowledge of Physician coding & hospital coding is an added advantage. Successful completion of a certification program from AHIMA such as CCS, CCS-P, or AAPC such as CIC, COC, and CPC - Must be active during joining and verified. Experience in any EMR systems such as Epic, Cerner & Meditech. Must be an SME with up-to-date knowledge of ICD-10CM, CPT-4, Ambulatory payment classification (APC), and NCCI edits. Effective communication skills, presentation skills, and proficiency in MS Excel & PowerPoint. Education -Graduate or undergraduate with a high level of knowledge and relevant work experience. Shift timing: 8. 30 AM - 5. 30 PM or 1 PM - 10 PM IST, should be flexible to adapt shift timings on a need basis. Responsibilities Oversee CBOS Department Operations Capacity planning based on monthly goals, managing inventory and leaves. Responsible for managing the allocation & workflows, identifying risks, and mitigation. Reporting the weekly and monthly performance to key stakeholders, taking initiative for the identified areas of improvement. Team management of direct reports across multiple employee levels Setting KPI goals, reviewing the performance metrics, coaching, and feedback to enable the team to meet KPI goals consistently. Working with training and QA functions to identify training needs, tweaking training programs to keep the team up to date on client-specifics, industry updates such as coding clinics HCPCS, CPT assistant, and annual updates on ICD 10CM, CPT-4. Contribute and inspire team-wide development through valuable content sharing, rewards & recognition, and implementing best people management practices such as team bonding. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm. com Visit us on Facebook Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm. com Visit us on Facebook

Key Skills: Strong knowledge of medical terminology, coding (CPT, ICD-10), and billing practices. Proficient in Microsoft Office Suite and healthcare billing software. Excellent attention to detail and strong organizational skills. Required Candidate profile Preferred Candidate Profile: Graduate in any stream is mandatory. Should have proficiency in Typing (25 WPM with 95% of accuracy) Should be flexible with 24*7 shift. Freshers can apply.

Accurately transforms medical diagnoses and procedures into designated alphanumerical codes in ICD-10-CM , CPT and HCPCS codes. Ensure that the daily coding volumes for the team are turned around accurately within the specified Turnaround Time. Checking input volumes allotted by TL Coding reports as per client guidelines and coding guidelines by maintaining operational quality and productivity. Regular interaction with TL and getting feedbacks. This position requires that one performs well independently and in a collaborative manner with their entire coding team. Understands in detail the workflow, procedures and specific criteria for the assigned client. Ensures he/she meets the monthly target with above 95% accuracy consistently Attend the Weekly QA / Team meetings without fail and respond in two way communication with the Quality analyst/Team Lead. Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Minimum Qualification Any Life science, Paramedical Graduates and Post Graduates Minimum Experience and skills Minimum Experience: 3-4 year experience. Basic Skill set: Strong ability to interpret medical records of the patients in different specialties. Ability to communicate, have excellent interpersonal, listening skills and organizational skills. Ability to work with speed and accuracy. Good analytic skills and expertise to be proficient in accurately coding medical records utilizing ICD-10-CM and CPT conventions especially Responsibility Accurately transforms medical diagnoses and procedures into designated alphanumerical codes in ICD-10-CM , CPT and HCPCS codes. Ensure that the daily coding volumes for the team are turned around accurately within the specified Turnaround Time. Checking input volumes allotted by TL Coding reports as per client guidelines and coding guidelines by maintaining operational quality and productivity. Regular interaction with TL and getting feedbacks. This position requires that one performs well independently and in a collaborative manner with their entire coding team. Understands in detail the workflow, procedures and specific criteria for the assigned client. Ensures he/she meets the monthly target with above 95% accuracy consistently Attend the Weekly QA / Team meetings without fail and respond in two way communication with the Quality analyst/Team Lead. Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Shall understand and abide by the organizations information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Minimum Qualification Any Life science, Paramedical Graduates and Post Graduates Minimum Experience and skills Minimum Experience: 3-4 years experience. Basic Skill set: Strong ability to interpret medical records of the patients in different specialties. Ability to communicate, have excellent interpersonal, listening skills and organizational skills. Ability to work with speed and accuracy. Good analytic skills and expertise to be proficient in accurately coding medical records utilizing ICD-10-CM and CPT conventions especially in Multispecialty Surgery. .

Responsible for accurate coding of medical records using ICD-10, CPT, HCPCS. Ensure compliance with regulations, optimize reimbursement, and review documentation experience, CPC/CCS certification required.

Dear All, Greetings from Flatworld Healthcare Services. WE ARE HIRING !! Job Title: CPC Certified Medical Coder in Multi-Specialty (Primary Care, Dental & Chiropractic) Location: Bangalore Shift: Night Shift Experience: 1 - 3 Years Notice Period: Immediate Joiners Preferred Employment Type: Full-Time, Permanent Interested candidates can share their CVs at pavan.v@finnastra.com or contact 9035473861 (Available between 11 AM - 9 PM ). Job Description: We are seeking a CPC-certified Medical Coder with a minimum of 2 years of experience in multi-specialty coding, specifically in Primary Care, Dental, and Chiropractic services within Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) settings. The ideal candidate should have strong expertise in CPT, ICD-10, HCPCS coding, and compliance with CMS and payer-specific guidelines. Key Responsibilities: Accurate Coding: Assign and review CPT, ICD-10, and HCPCS codes for Primary Care, Dental, and Chiropractic services, ensuring compliance with RHC/FQHC billing regulations. Claims & Compliance: Ensure claims meet payer policies, Medicare/Medicaid regulations, and RHC/FQHC-specific coding guidelines. Audit & Quality Assurance: Conduct internal coding audits, identify discrepancies, and implement corrective actions to improve accuracy. Denial Management: Work with the billing team to review and resolve coding-related denials and rejections. Documentation Review: Collaborate with providers to ensure appropriate documentation supports coding and reimbursement. Coding Education: Provide feedback and training to providers and staff on documentation improvement and coding updates. Stay Updated: Keep abreast of CMS, Medicaid, and commercial payer guidelines , ensuring compliance with evolving industry standards. Qualifications & Skills: Certification: Certified Professional Coder (CPC) from AAPC (Required). Experience: Minimum 2 years of multi-specialty coding experience in Primary Care, Dental, and Chiropractic services. Preferred Experience: Working knowledge of RHC/FQHC billing and coding guidelines. Software Proficiency: Experience with EHR/EMR systems and coding tools . Regulatory Knowledge: Understanding of Medicare/Medicaid billing , HIPAA, and compliance regulations. Analytical & Communication Skills: Strong attention to detail and ability to communicate effectively with providers and billing teams. Preferred Qualifications: Experience with Medicaid and Medicare Advantage plans . Additional certifications such as CRC, COC, or CPMA are a plus. Prior experience in denial management and revenue cycle optimization . Benefits: Competitive salary & performance incentives. Health benefits & professional development opportunities. Flexible work environment ( Remote/Hybrid as per company policy ).

Medical coder/Sr. Medical Coder PRINCIPLE PURPOSE OF JOB We are currently seeking a medical coder to support a growing client base. The medical coder is a key member of payer side medical claims audit team. The medical coder is responsible for analyzing and interpreting and assigns correct codes for the descriptions available on various medical procedures and diagnoses as per the medical policy requirements. JOB RESPONSIBILITIES Accurately analyzes provider documentation and ensure that appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT codes. Follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies. Evaluates medical records for consistency and adequacy of documentation. Maintains compliance standards as per the policies and reports compliance issues as required. ATTRIBUTES AND BEHAVIORS Develops and maintains positive working relationships with others. Shares ideas and information. Team player. Takes pride in the achievement of team objectives. Has credibility with peers and senior managers. Self-motivated driven to achieve results. Keeps pace with change acquires knowledge/skills as the business evolves. Handles confidential information with sensitivity. RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS Bachelors degree in any stream (preferably Life Science). Certified Professional Coder (CPC) from the American Academy of Professional Coders (AAPC) with knowledge of HCPCS, ICD, CPT, and DRG preferred. Minimum one year of experience in medical coding. Knowledge of ICD-10 coding preferred. SKILLS & COMPETENCIES Analytical thinking and problem solving skills. Good verbal and written communication skills. Excel proficiency. Ability to work independently and accomplish targets in a timely manner. JOB DEMANDS Ability to work seated at a computer for long periods of time. Candidate should be ready to work in night shift. KEY CONSTITUENTS No direct reports. Works with all Cotiviti business teams, especially with the medical coding team.

Analyze medical records and documentation to identify services provided during patient evaluations and management Assign appropriate E&M codes based on the level of service rendered and in accordance with coding guidelines and regulations (e.g., CPT, ICD-10-CM, HCPCS) Ensure coding accuracy and compliance with coding standards, including documentation requirements for various E&M levels Stay up-to-date with relevant coding guidelines, including updates from regulatory bodies (e.g., Centers for Medicare and Medicaid Services, American Medical Association) Adhere to coding regulations, such as HIPAA (Health Insurance Portability and Accountability Act) guidelines, to ensure patient privacy and confidentiality Follow coding best practices and maintain a thorough understanding of coding conventions and principles Collaborate with healthcare professionals, including physicians, nurses, and other staff members, to obtain necessary information for coding purposes Communicate with providers to address coding-related queries and clarify documentation discrepancies Work closely with billing and revenue cycle teams to ensure accurate claims submission and facilitate timely reimbursement Conduct regular audits and quality checks on coded medical records to identify errors, inconsistencies, or opportunities for improvement Participate in coding compliance programs and initiatives to maintain accuracy and quality standards Job Requirements Certified Professional Coder (CPC) or equivalent coding certification (e.g., CCS-P, CRC) In-depth knowledge of Evaluation and Management coding guidelines and principles Proficient in using coding software and Electronic Health Record (EHR) systems Familiarity with medical terminology, anatomy, and physiology Strong attention to detail and analytical skills Excellent communication and interpersonal skills Ability to work independently and as part of a team Compliance-oriented mindset and understanding of healthcare regulations Strong organizational and time management abilities Continuous learning mindset to stay updated on coding practices and changes

Role & responsibilities Team Leadership & Management: Supervise, mentor, and manage a team of medical coders, ensuring high-quality performance and productivity. • Coding Compliance & Accuracy: Monitor and maintain coding accuracy, compliance with regulatory standards, and adherence to coding guidelines such as ICD-10, CPT, HCPCS, and CMS regulations. • Quality Assurance: Review regular audits of coded records to ensure accuracy and compliance, providing feedback and training as necessary. Process Optimization: Identify areas for improvement in coding workflows and implement process enhancements to improve efficiency. • Training & Development: Provide ongoing education and training to team members on coding updates, industry changes, and best practices. • Collaboration: Work closely with US Clients other stakeholders to resolve coding discrepancies and ensure seamless production. • Reporting & Analysis: Generate reports on coding productivity, accuracy rates, and trends, presenting findings to senior management. Regulatory Compliance: Stay updated with changes in federal, state, and payer-specific coding regulations and implement necessary updates. • Issue Resolution: Address and resolve escalated coding issues and denials efficiently • Serve as the primary point of contact for clients, ensuring professional and courteous communication. • Issue Resolution: Address and resolve escalated coding issues and denials efficiently.information. Required Skills and Qualifications: • Education: o Bachelors degree medical related field is preferred. Required Skills and Qualifications: • Education: o Bachelors degree medical related field is preferred. Certifications (Preferred): Must hold one or more relevant certifications such as CPC (Certified Professional Coder), CCS (Certified Coding Specialist), COC (Certified Outpatient Coder), or RHIT (Registered Health Information Technician), CPMA. Experience: Minimum 5+ years of hands-on medical coding experience, with at least 2 years in a leadership or supervisory role. o Experience with various coding systems (ICD-10, CPT, HCPCS, etc.) and knowledge of medical terminology, anatomy, and physiology. o Oncology experience is a must. Perks and benefits Competitive salary and benefits, including health insurance and paid time off.

Education: Diploma Bachelor's degree in related field (preferred). Experience: Minimum 3-5 years of experience in revenue cycle, healthcare finance or medical billing. Experience leading a team or managing revenue cycle processes. Analytical Skills: Strong problem-solving and analytical abilities. Strong understanding of medical coding (CPT, ICD-10, HCPCS) and insurance regulations. Ability to work collaboratively with cross-functional teams and payers. Communication Skills: Excellent written and verbal communication. • Other Skills: Strong organizational and multitasking abilities. Compensation and Benefits • Competitive salary and benefits, including health insurance and paid time off. Leadership & Team Management: Supervise and guide a team of RCM specialists to ensure smooth workflow and operational efficiency. Set performance benchmarks, monitor key metrics, and provide coaching and training to enhance team productivity. Conduct regular team meetings to address challenges, discuss process improvements, and ensure adherence to policies.

Job Title: Medical Coder Surgery Coding (Series 1 to 6) Location: Kochi, Kerala (Hybrid) Must work from office in Kochi for first 3 Months Job Type: Full-Time Job Summary: We are seeking a detail-oriented and experienced Medical Coder specializing in Surgery Coding (Series 1 to 6) to join our team. The ideal candidate will be responsible for accurately assigning CPT, ICD-10-CM, and HCPCS codes for surgical procedures while ensuring compliance with regulatory guidelines and payer-specific requirements. Key Responsibilities: - Review and analyze medical records to accurately assign surgical procedure codes (Series 1 to 6). - Apply ICD-10-CM, CPT, and HCPCS Level II coding guidelines to ensure correct reimbursement. - Ensure coding accuracy and compliance. - Collaborate with physicians, healthcare providers, and billing teams to resolve coding discrepancies. - Stay updated on changes in medical coding guidelines, payer policies, and surgical procedures. - Perform coding audits and quality reviews to maintain high accuracy and compliance standards. - Assist in appeals and denials management by providing proper coding justifications. - Maintain confidentiality and adhere to HIPAA regulations. Required Qualifications & Skills: - CPC or equivalent coding certification. - Minimum 2 years of experience in medical coding, specifically in surgery coding (Series 1-6). - Strong understanding of surgical procedures and operative reports. - Proficiency in ICD-10-CM, CPT, HCPCS Level II coding systems. - Experience with EHR/EMR systems and medical coding software, prefer 3M. - Strong analytical and problem-solving skills. - Excellent communication and collaboration skills. - Attention to detail and ability to work independently.

Ortho Coders • Assign ICD-10, CPT, HCPCS codes for orthopedic treatments, surgeries • Review, validate clinical documentation for coding accuracy • Ensure compliance, coding guidelines, payer policies • Conduct coding quality audits, error correction Required Candidate profile E&M IP/OP Coders • Assign E&M codes (CPT, ICD-10, HCPCS) for inpatient, outpatient • Review physician documentation for medical necessity and compliance • Adherence to CMS, AAPC, and AHIMA guidelines Perks and benefits Plus incentives and Perks

Experience: Minimum 1 year in Medical Coding (ED Blended) Certification: CPC or CCS (Mandatory) Education: Graduate (Any Stream) Key Responsibilities: Review and accurately code Emergency Department (ED) medical records. Assign appropriate ICD-10, CPT, and HCPCS codes based on medical documentation. Ensure compliance with coding guidelines and regulatory standards. Collaborate with physicians and billing teams to clarify documentation when needed. Conduct audits and maintain accuracy in coding to minimize denials. Stay updated with industry coding changes and best practices. Required Skills & Qualifications: Minimum 1 year of experience in ED medical coding. CPC or CCS certification is mandatory. Strong knowledge of ICD-10, CPT, and HCPCS coding. Excellent attention to detail and accuracy. Strong analytical and problem-solving skills. Familiarity with healthcare compliance and regulations

Experience: Minimum 1 year in Medical Coding (EM/IP) Certification: CPC or CCS (Mandatory) Key Responsibilities: Review and analyze patient medical records for accurate coding of Evaluation & Management (EM) and Inpatient (IP) services. Assign appropriate ICD-10, CPT, and HCPCS codes based on documentation. Ensure compliance with coding guidelines and regulatory requirements. Work closely with physicians and billing teams to resolve documentation discrepancies. Conduct quality checks and maintain accuracy standards in coding. Stay updated with coding regulations and industry best practices. Required Skills & Qualifications: Minimum 1 year of experience in EM/IP coding. CPC or CCS certification is mandatory. Strong understanding of ICD-10, CPT, and HCPCS coding guidelines. Excellent attention to detail and accuracy. Strong communication and analytical skills. Familiarity with healthcare compliance and regulatory requirements.