Healthcare Reimbursement Coder

You will be responsible for reviewing outpatient medical records and assigning accurate ICD-10-CM, CPT, and HCPCS codes. Ensuring compliance with CMS, AMA, NCCI edits, and payer-specific guidelines will be a key part of your role. Your tasks will include coding charts for outpatient services like OPD visits, diagnostic services, minor procedures, therapy, labs, and radiology. Validating medical necessity and ensuring alignment between documentation and assigned codes will also be crucial. Collaboration with providers to clarify documentation and improve accuracy is expected. You will work with billing and AR teams to resolve coding-related denials and support appeals. Periodic self-audits will be conducted by you to maintain high accuracy levels. Staying updated with coding rules, annual guideline updates, and regulatory changes is essential.

Qualifications Required:

• Minimum 5 years of experience in outpatient coding
• Strong knowledge of outpatient coding rules and guidelines
• Expertise in ICD-10-CM, CPT, HCPCS Level II, and E/M outpatient guidelines
• Hands-on experience with EHR/EMR systems and coding platforms
• Ability to read and interpret provider documentation accurately
• Good understanding of outpatient billing workflow and payer policies
• Strong analytical and problem-solving skills
• Excellent communication and attention to detail

Edvak is a US-based SaaS company that specializes in transforming the healthcare sector with innovative AI solutions. Dedicated to excellence, creativity, and innovation, Edvak delivers exceptional services to clients. The company's operations in India are based in the vibrant city of Hyderabad. You will be responsible for reviewing outpatient medical records and assigning accurate ICD-10-CM, CPT, and HCPCS codes. Ensuring compliance with CMS, AMA, NCCI edits, and payer-specific guidelines will be a key part of your role. Your tasks will include coding charts for outpatient services like OPD visits, diagnostic services, minor procedures, therapy, labs, and radiology. Validating medical necessity and ensuring alignment between documentation and assigned codes will also be crucial. Collaboration with providers to clarify documentation and improve accuracy is expected. You will work with billing and AR teams to resolve coding-related denials and support appeals. Periodic self-audits will be conducted by you to maintain high accuracy levels. Staying updated with coding rules, annual guideline updates, and regulatory changes is essential.

Qualifications Required:

• Minimum 5 years of experience in outpatient coding
• Strong knowledge of outpatient coding rules and guidelines
• Expertise in ICD-10-CM, CPT, HCPCS Level II, and E/M outpatient guidelines
• Hands-on experience with EHR/EMR systems and coding platforms
• Ability to read and interpret provider documentation accurately
• Good understanding of outpatient billing workflow and payer policies
• Strong analytical and problem-solving skills
• Excellent communication and attention to detail

Edvak is a US-based SaaS company that specializes in transforming the healthcare sector with innovative AI solutions. Dedicated to excellence, creativity, and innovation, Edvak delivers exceptional services to clients. The company's operations in India are based in the vibrant city of Hyderabad.