Role & responsibilities
- Medical Coder (Denial Management)
- Review and analyze medical records, clinical documentation and insurance claims for coding accuracy.
- Perform Physician Coding / Professional Fee (Pro-fee) Coding using ICD-10, CPT codes and appropriate modifiers.
- Handle Coding Denial Management and identify reasons for claim denials.
- Review and interpret EOBs (Explanation of Benefits) to understand denial reasons and determine appropriate actions.
- Ensure accurate coding and compliance with medical coding guidelines, insurance regulations and documentation requirements.
- Understand and validate medical necessity requirements for procedures and services.
- Identify coding discrepancies, documentation gaps and errors, and coordinate with relevant teams for clarification.
- Maintain accuracy, quality and productivity while meeting defined SLAs and turnaround times.
- Ensure compliance with healthcare documentation standards and patient data confidentiality.
- Collaborate with operations and quality teams to improve coding accuracy and process efficiency.



Preferred candidate profile
- Medical Coder (Denial Management)
- Minimum 4 years of recent and relevant clinical, hospital or healthcare-related experience.
- Experience in Coding Denial Management is mandatory.
- Hands-on experience in Physician Coding / Professional Fee (Pro-fee) Coding is required.
- Candidates with Facility Coding experience only are not suitable for this position.
- Strong knowledge of CPT, ICD-10 and medical coding modifiers.
- Ability to read, understand and interpret EOBs (Explanation of Benefits).
- Good understanding of medical necessity requirements and insurance claim processing.
- Bachelor's degree in any Science-related field is preferred.
- Knowledge of US Healthcare and Revenue Cycle Management processes.
- Excellent analytical, communication and documentation skills.
- Solid attention to detail with the ability to work independently and meet quality standards.

📌 Medical Coder (Hyderabad)
🏢 NexCen IT Services
📍 Hyderabad