Job Title: Executive Coder

Experience: 12 Years

Qualification: Any Graduate

Certification: Active CPC (Certified Professional Coder) Certification is mandatory

Job Summary

We are looking for a detail-oriented Denial Coding with 12 years of experience in medical coding and denial management. The candidate will be responsible for reviewing denied healthcare claims, identifying denial reasons, validating medical coding accuracy, and supporting the appeals and claims resolution process in accordance with payer guidelines and coding regulations.

Key Responsibilities

- Review denied medical claims and identify the root cause of denials.
- Analyze medical records, clinical documentation, and coding details to validate claim accuracy.
- Identify coding-related denials, including incorrect ICD-10-CM, CPT, and HCPCS codes, as applicable.
- Review denial codes, remittance advice, and Explanation of Benefits (EOB) documents.
- Investigate claim denials related to medical necessity, authorization, eligibility, and coding discrepancies.
- Correct coding errors and recommend appropriate claim adjustments or resubmissions.
- Support the preparation of appeals and reconsideration requests with relevant clinical and coding documentation.
- Ensure compliance with official coding guidelines, payer policies, and healthcare regulations.
- Coordinate with billing, coding, and denial management teams to resolve outstanding claims.
- Maintain accurate records of denial trends, root-cause analysis, and resolution outcomes.




- Meet established productivity, quality, and turnaround-time (TAT) targets.

Required Qualifications

- 12 years of relevant experience in denial coding or denial management.
- Active CPC (Certified Professional Coder) certification from AAPC.
- Solid knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Understanding of US healthcare billing, claims processing, and payer denial codes.
- Experience reviewing medical records and identifying coding discrepancies.
- Knowledge of claim appeals, resubmissions, and denial resolution workflows.
- Strong analytical skills, attention to detail, and communication abilities.

Preferred Skills

- Experience working with US healthcare clients.
- Familiarity with EOBs, ERAs, and remittance advice.
- Knowledge of medical terminology, anatomy, and disease processes.
- Ability to analyze denial trends and recommend corrective actions.
- Proficiency in medical billing systems and electronic health records.

Key Performance Indicators (KPIs)

- Coding accuracy and quality scores.
- Denial resolution rate.
- Productivity and turnaround time.
- Reduction in recurring coding-related denials.
- Compliance with payer guidelines and organizational standards.

Employment Type: Full-time
Work Location: As per company requirements
Experience Level: 1–2 Years

Shifts : US Shifts

Interested Candidates can share your profile to below mentioned mail ID: [email protected] / Wats app the CV to (phone hidden).

📌 Coder Executive (Hyderabad)
🏢 Sagility India
📍 Hyderabad