As an E&M Outpatient (OP) Coder & QA Specialist based in Coimbatore, Tamil Nadu, your role will involve accurately coding and reviewing evaluation and management (E&M) coding. You will be responsible for ensuring compliance with coding guidelines and regulations in this full-time on-site position. Your key responsibilities will include: - Accurately coding and reviewing evaluation and management (E&M) coding - Ensuring compliance with relevant coding guidelines and regulations To qualify for this role, you must have: - Graduation in any field - Minimum 1 year of experience in E&M OP - Any certification from AHIMA/AAPC This position requires expertise in E&M coding for specialties such as Gatro, ENT, Radiology, Allergy, Ortho, OBGYN, Cardio, Dermatology, Surgery specialties like Gatro, ENT, Cardio, Urology, Ortho. Additionally, experience in Coder & QA roles will be beneficial.,
Company Description : MD Consultancy Solutions Pvt Ltd (MDCS) is a Healthcare BPO service provider specializing exclusively in the U.S. Healthcare RCM and Medical Coding industry. Established in 2020, MDCS is a privately owned, debt-free organization with extensive experience in the U.S. healthcare sector. The company is committed to delivering quality-driven services that enhance processes and elevate client satisfaction. MDCS is dedicated to navigating the complexities of the ever-evolving healthcare landscape and supporting businesses and practices in achieving their goals. Roles & Responsibilities: Analyze provider and payer contracts and translate reimbursement terms. Communicate professionally with clients and internal teams, meeting all productivity and quality goals. Understand payer reimbursement methods, and support additional tasks as needed. Eligibility: Excellent Communication Skill 1+ year experience in medical coding Any certification from AHIMA or AAPC Qualifications : Any Graduate Location : Delhi / NCR Mode : Work From Home (WFH) Note : Pref Medical Coder
About the Company : We are looking for a Quality Expert (QE) with strong domain expertise in Eligibility Verification & Benefits Validation (EVBV) and Prior Authorization processes. The QE will act as a quality owner, ensuring accuracy, compliance, and end-to-end validation of healthcare payer–provider workflows, business rules, and integrations. Responsibilities : EVBV (Eligibility Verification & Benefits Validation) Act as a subject matter expert for EVBV workflows and payer benefit structures Validate member eligibility, coverage status, plan details, copays, deductibles, coinsurance, and benefit limitations Ensure correctness of real-time, batch, and EDI 270/271 eligibility transactions Review and validate payer-specific rules and mappings Identify gaps in requirements and proactively raise quality risks Ensure data integrity across downstream systems consuming EVBV results Prior Authorization Serve as a quality gatekeeper for prior authorization workflows Validate authorization rules based on CPT/HCPCS, ICD-10, payer policies, and medical necessity Ensure accurate handling of authorization life cycle: submission, pend, approval, denial, partial approval Validate EDI 278 transactions and payer portal integrations Ensure compliance with TAT, SLA, and regulatory requirements Perform root cause analysis for authorization failures and quality issues Qualifications : 3+ years of experience in healthcare quality roles Strong domain expertise in EVBV and Prior Authorization Deep understanding of EDI transactions: 270/271, 278 Knowledge of payer benefits, authorization policies, and regulatory requirements Experience validating API, batch, and EDI integrations Strong defect analysis, documentation, and communication skills Required Skills : Experience in revenue cycle management (RCM) Claims or downstream adjudication knowledge Prior role as SME / Quality Lead / Quality Analyst Pay range : Upto 6LPA Contact : +91 95272 49946 / +91 72197 17605
Role Overview: You will be working as an E&M Outpatient (OP) Coder & QA Specialist in Coimbatore, Tamil Nadu. Your main responsibility will be accurately coding and reviewing evaluation and management (E&M) coding, ensuring compliance with coding guidelines, and regulations. This is a full-time on-site role. Key Responsibilities: - Accurately code and review evaluation and management (E&M) coding - Ensure compliance with relevant coding guidelines and regulations Qualifications Required: - Graduate in any field - Minimum 1 year experience in E&M OP - Any certification from AHIMA/AAPC (Note: No additional details of the company are mentioned in the job description.) Role Overview: You will be working as an E&M Outpatient (OP) Coder & QA Specialist in Coimbatore, Tamil Nadu. Your main responsibility will be accurately coding and reviewing evaluation and management (E&M) coding, ensuring compliance with coding guidelines, and regulations. This is a full-time on-site role. Key Responsibilities: - Accurately code and review evaluation and management (E&M) coding - Ensure compliance with relevant coding guidelines and regulations Qualifications Required: - Graduate in any field - Minimum 1 year experience in E&M OP - Any certification from AHIMA/AAPC (Note: No additional details of the company are mentioned in the job description.)
Company Description MD Consultancy Solutions Pvt Ltd (MDCS) is a Healthcare BPO service provider with a dedicated focus on the US Healthcare Revenue Cycle Management (RCM) and Medical Coding industry. Established in 2020, MDCS has built a reputation for quality and commitment to improving overall processes and client satisfaction. As a privately owned and financially stable organization, MDCS leverages its expertise to support businesses and practices in adapting to the evolving healthcare landscape. The company is dedicated to helping clients achieve operational excellence and success in the dynamic healthcare industry. Role Description This is a full-time remote role for an AR Caller (Fresher). The AR Caller will be responsible for working on accounts receivable processes for US Healthcare clients, which includes contacting insurance companies on behalf of providers to collect outstanding payments, verifying claim statuses, and resolving any issues. The role requires effective communication with payers and maintaining accurate documentation of calls and actions to ensure timely and efficient process completion. Qualifications Effective verbal communication and listening skills to interact confidently with insurance representatives and clients. Basic knowledge of US healthcare processes, particularly in accounts receivable and insurance claims, is beneficial. Ability to work independently in a remote setup, coupled with strong time management and organizational skills. Proficiency in MS Office tools and computer literacy to manage documentation and related processes. Positive attitude, willingness to learn, and adaptability to a fast-paced work environment.