RCM Coding Specialist

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• 2024 Black Book Awards, ranked #1 EHR in 11 Specialties
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• 2024 Stevie American Business Award (Silver), New Product and Service: Health Technology Solution (Klara)

Who we are:

We Are Modernizing Medicine (WAMM)! We’re a team of bright, passionate, and positive problem-solvers 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. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed is based in Boca Raton, FL, with office locations in Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US.

At Modernizing Medicine, we look for passionate, innovative, creative Rock Stars!

Who We Are

We Are Modernizing Medicine (WAMM)! We’re a team of bright, passionate, and positive problem-solvers 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. Founded in 2010 by Daniel Cane and Dr. Michael Sherling, we have grown to over 3400 combined direct and contingent team members serving eleven specialties, and we are just getting started! ModMed is based in Boca Raton, FL, with office locations in Santiago, Chile, Berlin, Germany, Hyderabad, India, and a robust remote workforce with team members across the US.

The Medical coding quality Auditor is a key position within the Modmed India Operations. Coders will be assigned to a group of practices under one or multiple specialties reporting to a specialty lead, while they are responsible for working on modifiers escalated by practice or Global Partners, a coder is responsible for observing and analyzing the areas and identifying opportunities to improve the process efficiency which will enhance the overall outcome for new and established customers.

Position Title – Medical coding Auditor 3

Your Role

• Audit the work done by Global Partners and provide timely feedback to teams to aid in the quick resolution of denied coding claims.
• Review & work on Coding denials from the Payers.
• Serve as a point of contact as coding SME for coding questions and clarifications for the MMI team.
• Review claims assigned to practices due to Coding issues in order to find out any trends and will work with CAs if practice education/ intervention is required.
• Analyse coding denials to determine trends where preventive measures can be placed, such as scrub edits, provider training, action plans, coder training, etc.
• Participates in coding educational opportunities (webinars, internal training, etc.). Will keep updated on the Payer Guidelines impacting on supplying the Codes.
• If needed, may assist in the production coding of clients of various specialties and scopes of coding.

Skills & Requirements:

• 5+ years of working experience in medical coding domain where minimum 2 years’ experience as SME/Quality in coding with Multi speciality experience
• Certification Mandatory - CPC
• Having strong knowledge in Gastro, Orthopaedics, Ophthalmology, Dermatology and Podiatry is preferred.
• Hands on knowledge of Coding Denials on providing the resolution.
• Good knowledge of Payer Guidelines to resolve the Denials related to Coding.
• Good writing and Verbal communication in English
• Can work independently during the India Night Shift
• Can run reports and analyze the trends and scenarios. A strong hand in MS Excel will be a plus
• Expert in supplying/auditing/ analyzing the CPT, ICD Codes along with appropriate Modifiers
• CPC from AAPC or CCS from AHIMA
• Bachelors or Masters in Science with a background of Anatomy

ModMed Benefits Highlight:

At ModMed, we believe it’s important to offer a competitive benefits package designed to meet the diverse needs of our growing workforce. Eligible Modernizers can enroll in a wide range of benefits, including:

• Comprehensive medical, dental, and vision benefits, including a company Health Savings Account contribution,
• 401(k): ModMed provides a matching contribution each payday of 50% of your contribution deferred on up to 6% of your compensation. After one year of employment with ModMed, 100% of any matching contribution you receive is yours to keep.
• Generous Paid Time Off and Paid Parental Leave programs,
• Company paid Life and Disability benefits, Flexible Spending Account, and Employee Assistance Programs,
• Company-sponsored Business Resource & Special Interest Groups that provide engaged and supportive communities within ModMed,
• Professional development opportunities, including tuition reimbursement programs and unlimited access to LinkedIn Learning,
• Global presence and in-person collaboration opportunities; dog-friendly HQ (US), Hybrid office-based roles and remote availability for some roles,
• Weekly catered breakfast and lunch, treadmill workstations, Zen, and wellness rooms within our BRIC headquarters.