Modernizing Medicine, Inc. (ModMed) is a dynamic healthcare technology company dedicated to revolutionizing the healthcare industry. Our mission is to place doctors and patients at the forefront of care through innovative, specialty-specific cloud platforms. With a global presence and a team of over 3400 dedicated professionals, we are committed to improving medical practice success and patient outcomes.
Job Description:
As a Medical Coding Auditor 3 at Modernizing Medicine, Inc., you will play a crucial role in ensuring the accuracy and efficiency of our medical coding processes. Reporting to a specialty lead, you will be responsible for auditing coding work, providing timely feedback, resolving coding denials, and serving as a subject matter expert (SME) for coding-related queries. Your expertise in medical coding, along with strong analytical and communication skills, will contribute to the success of our operations.
Qualification : B.Pharm, M.Pharm, Msc, Bsc, Pharm.D, MBBS, BDS
Location: Hyderabad, India
Key Responsibilities:
- Audit coding work done by Global Partners and provide feedback for resolution of denied claims
- Review and resolve coding denials from payers
- Act as a coding SME for internal teams, offering guidance and clarification
- Analyze coding denials to identify trends and implement preventive measures
- Participate in coding educational opportunities to stay updated on industry guidelines
- Assist in coding production for clients across various specialties, if needed
Skills & Requirements:
- 5+ years of experience in medical coding, with at least 2 years as an SME/Quality Auditor
- Certification: CPC (Certified Professional Coder) mandatory
- Strong knowledge in Gastroenterology, Orthopaedics, Ophthalmology, Dermatology, and Podiatry preferred
- Hands-on experience in resolving coding denials and familiarity with payer guidelines
- Excellent written and verbal communication skills in English
- Ability to work independently during night shifts in India
- Proficiency in MS Excel for report generation and analysis
- Expertise in CPT, ICD codes, and modifiers
- Bachelor’s or Master’s degree in Science with a background in Anatomy
ModMed Benefit Highlights (India Specific):
- Competitive benefits package including medical coverage for employees, their families, and dependent parents
- Paid time off for volunteering in the community
- Opportunities for professional development and growth
- Collaborative and award-winning culture
