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.
Robust knowledge of CPT, ICD-10 and medical coding modifiers.
Ability to read, understand and interpret EOBs (Explanation of Benefits).
Positive 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 (India)
🏢 NexCen IT Services
📍 India