Job Description
We are seeking a dedicated and detail-oriented CPC Certified Medical Coder specializing in Internal Medicine and Pediatrics for a full-time, office-based position in Pune. The primary responsibility of this role is to accurately review, code, and audit outpatient medical records, ensuring strict compliance with CPT®, ICD-10-CM, and HCPCS guidelines. You will be a critical link in the revenue cycle, supporting optimal reimbursement, quality reporting, and regulatory adherence in a collaborative environment.
Key Responsibilities:
• Accurate Coding: Assign precise CPT, ICD-10-CM, and HCPCS Level II codes for outpatient encounters in Internal Medicine and Pediatrics.
• E/M & Preventive Care: Code Evaluation and Management services (office/wellness/preventive visits) and procedures like immunizations and injections with correct modifier application (e.g., 25, 59).
• Compliance & Documentation: Review physician documentation for accuracy, initiate queries for clarifications, and ensure compliance with CMS, AMA, NCCI, and HIPAA regulations.
• Quality & Audits: Support MIPS reporting with CPT Category II codes and participate in internal/external audits to identify and correct coding trends.
• Billing Support: Collaborate with the billing/RCM team to resolve coding denials, correct claim errors, and respond to payer inquiries.
Skill Requirement
The ideal candidate is a certified professional with proven experience in the specified specialties, possessing strong analytical skills and an unwavering commitment to accuracy and compliance. You should be proficient with coding guidelines, adaptable to various shifts, and able to work both independently and as part of a team.
Required Qualifications & Skills:
• Mandatory: Valid CPC Certification (AAPC).
• Experience: Minimum 1–3 years of hands-on coding experience in Internal Medicine and Pediatrics.
• Technical Knowledge: In-depth knowledge of CPT, ICD-10-CM, HCPCS and current E/M coding guidelines (2021–2026).
• System Proficiency: Experience with EHR/PM systems, preferably eClinicalWorks.
• Core Competencies: Exceptional attention to detail, strong analytical and communication skills, and the ability to meet productivity targets.