Job Summary

We are seeking a CPC Certified Multi-Specialty Denial Coder with experience in the US Healthcare Revenue Cycle Management (RCM) industry. The candidate will be responsible for reviewing, analyzing, and resolving coding-related denials, ensuring accurate coding compliance, maximizing reimbursement, and supporting clean claim submissions across multiple specialties.

Key Roles & Responsibilities

- Review and analyze denied claims to identify coding-related issues and determine the root cause of denials.
- Perform accurate medical coding for professional services across multiple specialties, including but not limited to Cardiology, Orthopedics, Internal Medicine, Family Practice, and Surgery.
- Apply appropriate ICD-10-CM, CPT, HCPCS, and Modifier coding guidelines to ensure claim accuracy and compliance.
- Resolve coding denials and prepare corrected claims for timely resubmission.
- Conduct detailed chart reviews and documentation audits to support coding corrections and appeal submissions.
- Work closely with AR Teams, Providers, and Billing Departments to address denial trends and improve first-pass claim acceptance.
- Identify underpayments, coding discrepancies, and reimbursement opportunities.
- Review payer policies, LCD/NCD guidelines,



and coding updates to ensure compliance with payer requirements.
- Prepare and submit coding-related appeals with supporting documentation when required.
- Monitor denial patterns and recommend process improvements to reduce future denials.
- Maintain productivity and quality standards as defined by the organization.
- Ensure compliance with HIPAA regulations, CMS guidelines, payer policies, and industry best practices.
- Participate in internal audits, quality reviews, and coding education initiatives.
- Keep current with coding changes, reimbursement regulations, and healthcare industry updates.

Required Qualifications
- CPC (Certified Qualified Coder) Certification is mandatory.
- Minimum 2+ years of experience in Medical Coding and Denial Management within the US Healthcare RCM industry.
- Strong knowledge of ICD-10-CM, CPT, HCPCS, Modifiers, and Medical Terminology.
- Experience working on multi-specialty coding and denial resolution.
- Understanding of E&M; coding guidelines and payer-specific requirements.
- Hands-on experience with EHR/EMR systems and medical billing software.
- Excellent analytical, communication, and problem-solving skills.

Pay: ₹30,000.00 - ₹60,000.00 per month

Work Location: In person

📌 Senior Medical Coder (Multi specialty- Denial Coder ) (Sahibzada Ajit Singh Nagar)
🏢 SGH Management India
📍 Sahibzada Ajit Singh Nagar