Senior Medical Coding Specialist

Company Description

CombineHealth is revolutionizing the healthcare industry by creating an AI Agents to Help Hospitals Fight Insurance Denials

Role Description

This role is for a Senior Medical Coder at CombineHealth, Bangalore location. The Senior Medical Coder will audit and code outpatient patient records, ensuring accuracy and compliance with coding guidelines. Additionally, they will help prepare the necessary materials to enhance the performance of CombineHealth's medical coding AI.

Essential Job Duties

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

• Analyze medical records to identify and assign relevant ICD-10 diagnostic codes, CPT procedure codes, E / M & HCC codes to outpatient visits, with specialities such as family medicine, Emergency Department, etc.
• Audit coded charts to identify coding errors
• Review medical records, including patient histories, examination findings, diagnoses, and treatment plans, to extract pertinent information for code assignment.
• Utilizes coding references, software tools, and electronic health records (EHR) to facilitate accurate and efficient code assignment.
• Maintain a high level of accuracy in code assignment to prevent claim denials, billing errors, and potential legal issues.
• Complies with coding standards of ethical coding and coding compliance guidelines, including adherence to HIPAA (Health Insurance Portability and Accountability Act) privacy regulations.
• Participate in ongoing education, training, and certification programs to enhance coding proficiency and maintain credentials.
• Demonstrates support and compliance with CombineHealth's mission, vision, values statement, goals and objectives and policies. Performs other duties or projects such as coding corrections as assigned by the manager.

Minimum Qualifications