Job Title: RCM & Medical Coding Specialist
Duration: Fulltime
Location: 100% Remote

Job Summary:
We are seeking a highly skilled Senior RCM & Medical Coding Specialist with 4+ years of experience in Revenue Cycle Management and Medical Coding. The ideal candidate will possess solid expertise in CPT, HCPCS, and ICD-10-CM coding guidelines, healthcare billing operations, denial management, and claims processing.

This role will support healthcare practices leveraging AI-powered clinical documentation and coding platforms to ensure accurate coding, billing-ready documentation, optimized reimbursement, and compliance with payer and regulatory requirements.

Key Responsibilities:

- Review and validate AI-generated SOAP notes, clinical documentation, and coding recommendations prior to claim submission.
- Assign and audit accurate CPT, HCPCS, and ICD-10-CM codes based on provider documentation and coding guidelines.
- Ensure all medical records support billed services and comply with payer-specific policies and industry regulations.
- Manage end-to-end Revenue Cycle Management activities, including charge capture, claim submission, payment posting, denial management, and AR follow-up.
- Review coding outputs generated through AI-assisted documentation solutions and identify opportunities for correction or optimization.
- Collaborate with providers and clinical staff to resolve documentation deficiencies and coding discrepancies.
- Analyze denied and rejected claims, identify root causes, and implement corrective actions.
- Monitor coding accuracy, reimbursement trends, and revenue leakage opportunities.
- Support EHR-integrated workflows to ensure seamless movement of documentation from clinical encounters to billing processes.
- Conduct periodic coding audits and provide recommendations to improve compliance,



coding quality, and revenue performance.
- Stay updated on changes in ICD-10-CM, CPT, HCPCS, CMS regulations, and payer guidelines.
- Assist in optimizing AI-assisted coding and documentation workflows to improve operational efficiency and claim acceptance rates.

Required Qualifications:

- Bachelor's degree in Healthcare Administration, Life Sciences, Nursing, Medical Sciences, or a related field.
- Minimum 4+ years of experience in Medical Coding and Revenue Cycle Management.
- Strong knowledge of CPT, HCPCS, and ICD-10-CM coding guidelines.
- Experience in healthcare billing, claims adjudication, payment posting, denial management, and AR follow-up.
- Familiarity with AI-assisted clinical documentation, automated coding tools, or healthcare technology platforms.
- Experience reviewing SOAP notes and validating medical necessity for coded services.
- Strong understanding of E/M coding guidelines and documentation requirements.
- Knowledge of Medicare, Medicaid, and commercial payer policies.
- Experience working with EHR/EMR systems and healthcare practice management platforms.
- Excellent analytical, communication, and problem-solving skills.

Preferred Qualifications:

- CPC, CCS, CCA, CRC, or equivalent certification.
- Experience working with AI-powered medical scribing or coding solutions.
- Knowledge of clinical documentation improvement (CDI) practices.
- Experience in provider education, coding audits, and compliance reviews.

Technical Skills:

- Revenue Cycle Management (RCM)
- Medical Coding & Auditing
- CPT Coding
- HCPCS Coding
- ICD-10-CM Coding
- E/M Coding
- Denial Management
- Claims Processing
- Accounts Receivable Management
- Healthcare Compliance
- Clinical Documentation Review
- AI-Assisted Coding Validation
- EHR/EMR Systems
- Healthcare Analytics & Reporting

📌 RCM & Medical Coding Specialist (India)
🏢 ITResource Hunter
📍 India