Associate/Lead-Medical Coding
Location: Coimbatore
• Experience: Mid Level
• Openings: 26
Job description
Roles and Responsibilities
Assess complex medical
claims similar to AXA, AIA, Alliance Care
M form, VDS, or
clinical/medical backgrounds, specifically those familiar with ICD 9, ICD 10,
and CPT procedures for a Hong Kong project. US healthcare experience alone is
insufficient due to differences in process and code interpretation.
Review Clinical & Day
Case claims and approve/reject basis the SOP
Review Hospital Inpatient
& Outpatient Claims, analyse the vouchers/medical documents, categorize the
benefits as per the SOP and approve/reject basis the SOP
Provide guidance and support
to facilitate junior advisors resolve complex claims
Identify potential fraud,
waste, and abuse (FWA) Flag suspicious cases, highlight patterns, and work
with compliance teams to ensure early detection and escalation.
Must Have
2-5 Years of
Experience in the above listed work type/life science background/CPC certified