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Location: Hyderabad
Reports to: Sr. Manager, MMI (Administrative) | Manager, Medical
At ModMed, we are on a mission to place doctors and patients at the center of care through an intelligent, specialty-specific cloud platform. Our vision is a world where the software we build increases medical-practice success and improves patient outcomes.
Create Customer Delight and Save Time.
Innovate Boldly, then make things happen.
Align Passion with Purpose.
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The RCM Coding Specialist is a vital new role designed to make our team self-sufficient across the entire Revenue Cycle Management (RCM) cycle. This position serves as a Subject Matter Expert (SME), ensuring that medical coding is accurate, compliant, and optimized to reduce denials. You will bridge the gap between our global partners and US-based teams, providing the technical expertise necessary to improve patient outcomes and practice success.
Quality Assurance & Auditing (25%): Audit coding performed by Global Partners and provide timely feedback to resolve denied claims quickly.
Denial Management (20%): Review and resolve coding denials from payers, ensuring accurate resubmission and revenue recovery.
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Subject Matter Expertise (20%): Act as the primary point of contact for coding questions and clarifications for the MMI team.
Trend Analysis (15%): Review claims assigned to practices due to coding issues to identify trends; collaborate with Client Advisors (CAs) when practice education or intervention is needed.
Preventive Strategy (10%): Analyze denial data to recommend preventive measures, such as scrub edits, provider training, and internal action plans.
Continuous Learning (5%): Stay current with Payer Guidelines and participate in ongoing coding educational opportunities and webinars.
Production Support (5%): Assist in production coding for various client specialties and scopes as needed.
ModMed (Modernizing Medicine) provides specialty-specific EHR systems, practice management, and revenue cycle management software designed to simplify clinical workflows for medical practices.
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Mid · 5+ years experience
Onsite
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