Clinical Coder (India)

Clinical Coder (India)

12 Nov
|
Cognitio Analytics
|
India

12 Nov

Cognitio Analytics

India

Company Description Cognitio Analytics Inc., founded in 2013, helps large organizations improve productivity through data-driven and AI/ML-enabled solutions. The company offers Smart Operations Solutions that unlock the value of overlooked operations data and Total Rewards Analytics Solutions that optimize investments in human capital. Cognitio Analytics is recognized as world-class in its focus areas, with awards from the Business Process Intelligence Challenge 2018 and the Celonis Hackathon 2022, and its solutions are used by Fortune 100 companies for key decisions. The organization invests heavily in R&D; and innovative technologies, supported by a team of passionate analytics, technology, and business professionals. Certified as a “Great Place to Work,” Cognitio Analytics is growing and seeks impact-driven individuals, especially with experience in healthcare, insurance, and banking domains. Role Description The Clinical Coder will be responsible for reviewing medical records, interpreting clinical documentation, and assigning accurate diagnosis and procedure codes in accordance with established coding standards and payer guidelines. Day-to-day activities include validating completeness of documentation, ensuring compliance with regulatory and organizational policies, and collaborating with clinical and operations teams to clarify information and support accurate reimbursement. The role also involves performing data quality checks, supporting analytics teams with coded data for insights, and contributing to process improvement initiatives in clinical documentation and coding workflows. This is a contract position based in the Greater Delhi Area, structured as a hybrid role with a mix of in office work and some work-from-home flexibility. A. Coding Portfolio Execution & Development
• Support end-to-end clinical annotation, validation, and coding asset development activities across the portfolio.
• Drive improvements in encoded data coverage, accuracy, usability, and scalability aligned with global and regional implementations.
• Contribute to the design and development of coding frameworks, including:
• Foundation and expansion of coding across clinical domains.
• Crosswalks and mappings having downstream impact on Amplify Health products.
• Develop and refine GenAI prompts and training datasets to enhance clinical coding automation and model accuracy (would be a plus). B. Stakeholder Coordination
• Engage regularly with internal stakeholders, including product, data science, analysts, and coders, to align delivery priorities and coding requirements.
• Support external stakeholder engagements with clients, providers, and regulators to ensure coding standards and expectations are met. C.



Product & AI Enablement SupportPartner with product and data science teams to:
• Improve product features through enhanced coding logic.
• Support GenAI model development using structured coding inputs and prompt engineering.
• Provide ongoing support for coding-related initiatives, such as Rules & Benefits and Asset Management.
• Contribute to solution design, requirement gathering, and feature validation for healthcare products. D. Coding Research & Innovation
• Stay updated on international and APAC coding standards, classifications, billing practices, and regulatory changes.
• Conduct in-depth coding research and benchmarking across global healthcare systems (US, Canada, Australia, etc.).
• Extract and apply methodologies from leading healthcare organizations to strengthen internal coding practices. E. Annotation, Validation & Quality Assurance
• Oversee and contribute to annotation and validation across terminologies such as ICD, CPT, SNOMED CT, LOINC, and ATC.
• Ensure encoded data is clinically accurate, contextually relevant, and aligned with workflows and downstream use cases.
• Perform audits, quality checks, and variance analysis to ensure data integrity.
• Investigate discrepancies and propose resolution strategies for escalations.
• Review peer outputs, challenge assumptions, and provide structured feedback for continuous improvement.
• Support integration of validated data into Ground Truth datasets for analytics and AI modelling. F. Clinical Data Assessment & StandardizationSupport and execute market-specific data assessments, including:
• Data profiling and gap analysis.
• Feasibility and readiness for coding standardization. Contribute to schema design and data model validation, including:
• Clinical and billing schemas.
• Property structures and metadata frameworks. Ensure alignment of data structures with clinical workflows, regulatory standards, and business use cases. G. Team Support, Operations & Capability Building
• Contribute to the creation and maintenance of SOPs, coding principles, and validation guidelines.
• Support sprint planning, backlog grooming, and execution tracking.
• Ensure all documentation is updated and aligned with regulatory and operational standards.
• Provide training and mentorship on:
• Coding validation approaches.
• Market-specific requirements.




• Use of automation and AI tools in coding.
• Support capability building of team members and mentor junior coders.
• Facilitate knowledge sharing across regional and global teams. H. Cross-Portfolio SME Support
• Act as a Subject Matter Expert (SME) across clinical portfolios.
• Provide expert input on:
• Coding frameworks.
• Data standardization.
• AI/GenAI use cases in coding.
• Review outputs, provide actionable feedback, and ensure alignment with Clinical Informatics strategy. 3. Candidate Profile – Experience & QualificationsEducational Qualifications
• Graduate healthcare qualification is required.
• Preferred academic backgrounds:
• MBBS
• BDS
• BHMS
• BAMS
• Physiotherapy
• Pharmacy
• Any other medical field
• Master's degree in Health Informatics, Clinical Sciences, Public Health, or Health Administration is preferred. Experience
• 7+ years of experience in health insurance, clinical coding, or claims analytics within Asia or globally would be an advantage.
• Deep knowledge of:
• Clinical coding assets.
• Clinical terminologies.
• Healthcare billing practices.
• Regulatory frameworks. Stakeholder Management
• Strong stakeholder management and communication skills across clinical, operational, and regulatory domains. 4. Technical CompetenciesA working understanding of healthcare data is important, as data forms the basis of the organization's products. The following technical competencies are required:
• Understanding of healthcare-specific data.
• Reasonable competence in Microsoft Office tools, especially:
• Excel
• Access
• PowerPoint
• Knowledge of patient health management.
• Knowledge of provider profiling.
• Understanding of healthcare reporting and other key healthcare technologies.
• Detailed knowledge and working experience of clinical tools and international coding, including:
• Groupers
• Crosswalks
• Classification systems 5. Behavioral Skills & Core Characteristics
• Demonstrated ability to effectively lead and actively manage teams of experienced clinical and multidisciplinary experts.
• Exceptional communication skills across a wide range of stakeholders.
• Ability to work cohesively in a team environment while balancing multiple priorities.
• High level of attention to detail.
• Resilience, enthusiasm, energy, and drive.
• Positive, can-do attitude focused on continuous improvement.
• Ability to take feedback and constructive criticism to drive improved delivery.
• Strong problem-solving ability and ability to optimize the working workplace.
• Excellent coordination skills.

📌 Clinical Coder (India)
🏢 Cognitio Analytics
📍 India

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