Job DescriptionSenior Medical Coder – OP Clinic Coding Denial Management Hospital Outpatient Department (HOPD) Facility Coding Remote | Night Shift (5:30 PM – 1:30 AM IST) About Us Opti

Claim Business Solutions provides medical coding and revenue cycle services to U.S. healthcare providers, with a dedicated team supporting hospital outpatient clinic (HOPD) coding and denial resolution.

We're hiring experienced coders who bring accuracy to this hospital-based facility coding environment.

Role Overview This role sits within our Hospital Outpatient Department (HOPD) coding team, supporting hospital-owned outpatient clinics.

It is a facility coding role — not a professional fee (pro-fee) coding role.

You'll code outpatient clinic encounters under the hospital's facility structure, assign facility E/M levels using HCPCS G0463, and resolve coding denials on those claims in Claim

Source, working from root-cause identification through correction and resubmission.

Key Responsibilities Coding - Assign ICD-10-CM, CPT, HCPCS Level II, and modifiers for outpatient clinic (HOPD) encounters. - Level facility visits using HCPCS G0463, based on documentation. - Code outpatient surgeries/procedures, radiology & imaging, lab & pathology, and infusion services performed in the hospital-based clinic setting. - Assign revenue codes and support APC grouping for facility claims. - Apply NCCI/CCI edits and modifiers correctly within the facility coding structure.

Coding Denial Management - Review coding denials in Claim

Source and identify the root cause.



- Cross-check claim details in Cerner, 3M, and STAR to validate facility documentation. - Correct coding and resubmit denied claims; escalate billing-scope issues to the billing team. - Support hold-case review in 3M, resolving or escalating pending documentation issues before billing. - Track denial trends and flag fixes to prevent repeat denials. - Run coding quality checks/audits to keep facility coding accuracy high.

Must-Have Expertise - Facility E/M coding using HCPCS G0463, within a hospital outpatient clinic (HOPD) setting. - APC logic, revenue codes, and OCE edit resolution. - Coding denial investigation, correction, and resubmission via Claim

Source. - Outpatient facility coding: surgeries & procedures, radiology/imaging (CPT 70010–79999), lab & pathology (CPT 80047–89398), infusion services (CPT 96360–96379), and clinic specialties such as Cardiology, PT/OT, and Wound Care. - Common modifiers: -24, -25, -27, -57, -59, -73, -74, G0. - Hands-on experience with 3M, Cerner, Claim

Source, and STAR. - Comfortable working in a hospital-based (HOPD) facility coding workplace.

Qualifications - CPC, CCS, or equivalent coding certification. - 3+ years of outpatient facility (HOPD) coding experience. - 2+ years resolving coding denials in an outpatient facility setting. - Working knowledge of 3M, Cerner, Claim

Source, and STAR. - Prior experience coding for a hospital-owned outpatient clinic preferred, over independent physician office (pro-fee) coding.

Apply directly on the job post or send your resume to

📌 Senior Medical Coder - Outpatient Clinic Coding and Denial Management (India)
🏢 OptiClaim
📍 India