1613 Cpt Jobs - Page 36

Skills Skill Training Performance Management Employee Engagement Human Resources Talent Management Talent Acquisition Vendor Management Team Building Employee Relations Employee Training Business Development Education Qualification No data available CERTIFICATION No data available Job Summary The Senior Manager – Training (Medical Coding) is responsible for strategizing, designing, and delivering training programs that enhance the technical competency of coders in alignment with industry standards and client requirements. This role focuses on developing high-performing medical coding teams through robust onboarding, upskilling, and quality enhancement initiatives. The role also includes mentoring a team of trainers and collaborating with operations, quality, and HR teams. Key Responsibilities Training Strategy & Planning Design and implement the overall technical training strategy for medical coding teams (IPDRG). Conduct training needs assessments in collaboration with business stakeholders. Create annual and quarterly training roadmaps for new hires and existing employees. Program Development & Delivery Develop and update training content, manuals, and e-learning modules in line with current CPT, ICD-10, and HCPCS coding guidelines. Oversee delivery of new hire training (NHT), refresher training, cross-training, and certification prep (e.g., CPC, CCS). Ensure effective use of training tools, simulations, and assessments to evaluate knowledge retention. Team Leadership & Development Manage a team of technical trainers and senior trainers; provide coaching, support, and performance feedback. Build internal capabilities through Train-the-Trainer (TTT) programs and leadership development of trainers. Align training KPIs with business goals and continuously track trainer effectiveness. Quality & Compliance Collaborate with the Quality and Compliance teams to address audit findings, quality trends, and RCA-driven training. Ensure all training programs meet HIPAA regulations, payer guidelines, and client-specific standards. Support coders in achieving and maintaining relevant certifications and CEUs. Stakeholder Collaboration Partner with operations, client services, quality assurance, and HR to drive productivity and accuracy improvements through training. Present regular reports on training metrics, effectiveness, and ROI to senior leadership. Support transitions and ramp-ups with customized training plans for new projects or client accounts. - Education Any graduate; Certification in CPC, CCS, or equivalent is mandatory. Experience 13+ years in medical coding, with 5+ years in training leadership roles. Exposure to IPDRG coding is essential. Skills : Expertise in CPT, ICD-10, and HCPCS coding guidelines. Strong instructional design and facilitation skills. Experience with LMS and e-learning tools. Ability to analyse training impact using quality and productivity metrics. Key Competencies People management and leadership Technical acumen in coding standards and compliance Strategic planning and execution Communication and stakeholder management Analytical thinking and continuous improvement mindset

Skills Skill Vendor Management Service Delivery CRM Project Management Business Development MIS Operations Management BPO Process Improvement Telecommunications Education Qualification No data available CERTIFICATION No data available : Understand the quality requirements both from process perspective and for targets. To Train effectively the new joiners on Medical Coding concept with the guidelines. TomonitorTrainees productivity and quality output per OJT glide path/ramp up targets. Providing continuous feedback in a structured manner. Educating on the client specs and guidelines. Educating on the latest updates on the coding aspects. Carrying out one-on-one session on the repeated errors. To provide feedback on productivity and quality of trainees to Team Leads. To pass on the QC feedback effectively to the trainees. To help Team Leads in early confirmation of Trainees by providing the valuable inputs. Job Specification Minimum of 3 Years of Professional and Relevant Experience in Medical Coding with specialty Surgery. Extensive Coaching & Trainingas per process defined. Must have Variant Training & Coaching Strategy. Must have Coding Certification like CPC, CCS, COC, AHIMA. Any graduate will do. Shift Details:General Shift / Day Shift Work Mode:WFO

Skills Skill Education Qualification No data available CERTIFICATION No data available Job TitleProcess Coach Service LineCoding : Understand the quality requirements both from process perspective and fortargets. To Train effectively the new joiners on Medical Coding concept with the guidelines. TomonitorTrainees productivityand quality outputper OJT glide path/ramp up targets. Providing continuousfeeadbackin a structured manner. Educating on the client specs and guidelines. Educating on the latest updates on the coding aspects. Carrying out one-on-one session on the repeated errors. To provide feedback on productivity and quality of trainees to Team Leads. To pass on the QC feedback effectively to the trainees. To help Team Leads in early confirmation of Trainees by providing the valuable inputs. Job Specification: Minimum of 3 Years of Professional and Relevant Experience in Medical Coding with specialty Edits & Denials. Extensive Coaching & Trainingas per process defined. Must have Variant Training & Coaching Strategy. Must have CodingCertificationlike CPC, CCS, COC, AHIMA. Any graduate will do. ShiftDetailsGeneral Shift / Day Shift WorkModeWFO LocationHyderabad

Direct end-to-end billing operations including charge entry, claims submission, ERA posting, denial management, and accounts receivable follow-up Compliance Enforcement: Ensure adherence to HIPAA, CMS guidelines, and payer-specific requirements for coding (CPT, ICD-10) and billing practices Revenue Optimization: Analyze payer contracts and service line performance to maximize reimbursement rates and minimize denials Team Leadership: Manage billing/coding teams, conduct performance reviews, and provide training on healthcare-specific software Hospital-Specific Requirements Regulatory Expertise: In-depth knowledge of Medicare/Medicaid billing, forms, and hospital fee schedules. Software Proficiency: Experience with hospital information systems (HIS) and clearinghouses (e.g., Change Healthcare). Clinical Coordination: Collaborate with clinical departments to resolve documentation discrepancies affecting coding accuracy. Job Identification 28845 Posting Date 06/16/2025, 07:40 AM Apply Before 06/23/2025, 07:40 AM Degree Level Master's Degree Job Schedule Full time Locations 127, Shankarsheth Rd, , Pune, Maharashtra, 411042, IN Show more Show less

Job Title: Senior Associate - Account Receivables Years of Experience: 3 - 4 years Shift Timings: Night Shift (7:00 PM to 4:00 AM) Location: Hyderabad, Telangana Education Qualification: Any graduate Skill Set Requirements: Communication Skills - Grade A Analytical Skills - Grade A Experience and Domain Requirements: AR callers with good experience of 3+ Years RCM Experience (Physician Billing). Have PMS (Software) - AMD Understanding of Provider Information & Patient Information as it impacts claim resolution. Knowledge of Clearing House Rejections/Denials and its resolution Knowledge of Payor Denials and Resolution Knowledge of Appeals Process - Form types/Documents related to Appeals, Online Appeals Basic coding knowledge - ICD/CPT, E/M codes, code Series, Modifiers in Physician billing

Job Description: Charge Entry Specialist Position Title: Charge Entry Specialist Location: Bangalore ( WFO only) Job description Greetings from Omega Healthcare Pvt. Ltd.! We are currently hiring for Charge Entry & Payment Posting with minimum 1Year of experience into Medical Billing Domain. Basic Requirements: Experience: 1 Years to 5 Years Specialties :Charge Entry/Payment Posting Salary: Best in Industry Work Mode: WFO Notice Period: Immediate Joiners Shift: Day Key Responsibilities: Enter charge data into billing systems with accuracy and efficiency. Review and verify charge information for completeness and accuracy. Resolve discrepancies and issues related to charge entries. Collaborate with other departments to ensure proper billing practices and resolve any billing issues. Maintain up-to-date knowledge of billing codes and procedures. Generate and review reports related to charge entry and billing. Ensure compliance with relevant regulations and company policies. Interested candidate contact or share your updated resume to HR Venkatesh 8762650131/ Venkatesh.ramesh@omegahms.com Regards, Venkatesh R

Dear Aspirants, We are hiring for experienced IP DRG professionals to join our team at our Mohali location . Eligibility Criteria: Any graduate Mandatory certification in CIC / CCS Medical Coding Minimum 1 year of experience in IP DRG (Mandatory) Strong Communication Skills In-depth knowledge if In-Patient process Flexible to work in rotational shifts, including night shifts Looking for long term commitment If you meet the above requirement and are interested in this opportunity, please share your updated resume with us at: avinash.jeniga@cotiviti.com We look forward to hearing from you! Best regards, Cotiviti Talent Acquisition Team

Should be responsible for curriculum development. Responsible for mentoring the training resource across Kerala. Should be capable of taking Complete syllabus of RedTeam courses such as ADCD, CPT, CICSA, CSA, CCSA, CRTA, CEH, P+,S+,CYSA+,CHFI etc. Batches should be completed within the course duration, without affecting the quality of trainings. Your key performance indicators will be student placement, Student pass rate, projects, feedbacks, quality of trainings, interview preparation of students, maintaining course diary, attendance, proper evaluation etc. Should deliver sessions and workshops on innovative technology and topics in various colleges and events such as RedTeam Security Summit as instructed by the senior in charge Should be an active member of RedTeam research and development wing. Should take up request from RedTeam cyber security labs LLP as part of their corporate training requirements of clients or any requirement of your subject expertise as and when needed by the senior in charge. Should have the skill to learn and adapt new things and deliver Job Types: Full-time, Fresher Pay: ₹12,000.00 - ₹18,000.00 per month Benefits: Cell phone reimbursement Schedule: Day shift Morning shift Supplemental Pay: Performance bonus Ability to commute/relocate: Kottakkal, Kerala: Reliably commute or planning to relocate before starting work (Preferred) Education: Diploma (Required) Experience: total work: 1 year (Preferred) Trainer: 1 year (Required) Language: English (Required) Malayalam (Required) License/Certification: Cyber Security (Required) Shift availability: Day Shift (Required) Night Shift (Required) Work Location: In person

Walk-In Interview for Experienced Medical Coders at Vee Healthtek, Trichy on June 21 & 22 Experience : 1 to 7 Years experience on medical coding Specialty : IP DRG/Surgery/EM/ED Facility/ED Pro/Radiology/IVR - Medical Coding Job Location : Trichy,Chennai, Bangalore, Salem, Hyderabad & Pune - Work From Office Designation : Medical Coder/Sr Coder/QA/GC/TC AAPC Certification is Must Interview Schedule : June 21 & 22 at 10:00 TO 1PM Interview Venue: Vee Healthtek Pvt Ltd, No4, Bharathidasan Salai, Unit 2 -4th floor, Opposite to All India Radio, Cantonment, Trichy, Tamil Nadu - 620001 Important Note : Please mention my name, Kalaiyarasi Raja HR as Reference, at the top of your resume. Contact Information: Kalaiyarasi Raja- 9566406546(Available on WhatsApp) kalaiyarasi.r@veehealthtek.com Regards Kalaiyarasi Raja - HRD Vee HealthTek

Walk-In Interview for Life Science Graduates in Medical Coding at Vee Healthtek, Trichy on June 21 & 22, 2025 Eligibility : Graduates in Life Sciences Only (Candidates with non-life science degrees or diplomas or final year students/who has stand-in arrears are not eligible) Job Location : Trichy - Work From Office Interview Schedule : June 21 & 22, 2025 at 10:00 AM Sharp (Late Comers won't be allowed) Interview Venue: Vee Healthtek Pvt Ltd, No4, Bharathidasan Salai, Unit 2 -4th floor, Opposite to All India Radio, Cantonment, Trichy, Tamil Nadu - 620001 Compensation : CTC of 21,000 per month Shift Details : Rotational shifts as per business needs Interview Process : Two rounds (Technical Assessment & Final Oral Technical Interview) Joining Date : Immediate Required Documents for the Interview: Original 10th & 12th Mark Sheets and Resume Important Note : Candidates will be required to sign a minimum commitment of 18 months and submit the original 10th/12th Mark Sheets. Topics to Prepare for the Interview: - Human anatomy and physiology systems - General medical terminologies - Medical Coding, ICD, and CPT Contact Information: Kalaiyarasi- 9566406546 (Available on WhatsApp) kalaiyarasi.r@veehealthtek.com Important Note: Please be advised that only candidates who have successfully completed their studies and present original mark sheets will be permitted to attend the walk-in interview. Additionally, participation is limited to a maximum of 250 individuals per day, and entry will be granted on a first-come, first-served basis. Regards Kalaiyarasi Raja- HRD

Job highlights 2 to 3 years of experience in E&M and Surgery coding; Certification (CPC, CCS, or equivalent) preferred; Strong knowledge of coding guidelines Assign CPT, ICD-10, and HCPCS codes; Review medical records for coding compliance; Liaise with billing and audit teams Required Candidate Profile 2 to 3 years of hands-on experience in E&M and Surgery coding Certification (CPC, CCS, or equivalent) preferred Strong knowledge of coding guidelines and modifiers Willing to work night shift Role: Medical Biller / Coder Industry Type: Medical Services / Hospital Department: Healthcare & Life Sciences Employment Type: Full Time, Permanent Role Category: Health Informatics Regards, HR Team 8012137777 Job Type: Full-time Pay: ₹20,000.00 - ₹27,000.00 per month Benefits: Paid sick time Schedule: Day shift Supplemental Pay: Yearly bonus Work Location: In person

Hi, Job Title: Radiology / IVR / Denial Medical Coder Department: Medical Coding / Revenue Cycle Management Location: Velachery - Chennai Reports to: Coding Supervisor / Manager Salary: Max 38k CTC Work mode: WFH Notice period: Max 1Month / 15 Days Job Summary: We are seeking a detail-oriented and experienced Radiology Medical Coder to review and assign appropriate ICD-10-CM, CPT, and HCPCS codes for diagnostic and interventional radiology procedures. The ideal candidate will ensure accurate coding and compliance with current coding guidelines and payer requirements to optimize reimbursement and maintain audit readiness. Key Responsibilities: Review radiology reports and documentation to accurately assign CPT, ICD-10-CM, and HCPCS codes. Ensure coding is compliant with federal regulations and payer-specific guidelines. Work closely with radiologists, billing teams, and compliance personnel to clarify documentation. Maintain up-to-date knowledge of radiology coding changes and payer policies. Assist in resolving coding-related denials and rejections. Meet coding productivity and accuracy standards as defined by the department. Participate in internal audits and quality improvement activities. Maintain confidentiality and data integrity in all coding activities. Requirements: Minimum 6 Months of experience in radiology medical coding. Strong knowledge of anatomy, physiology, medical terminology, and radiology procedures. Proficient in using EMR/EHR systems and coding software. Excellent attention to detail and time management skills. Knowledge of Medicare, Medicaid, and commercial payer guidelines. Preferred Qualifications: Experience with Radiology or interventional radiology coding. Familiarity with NCCI edits and LCD/NCD policies. Remote work experience in a healthcare setting. If you are interested ping me Malini HR 9003239650 / 8925808598 (Call or whatsapp) Regards, GLOBAL MALINI HR 90032 39650

Company : ProBill RCM Location: Chandigarh, India Shift Timings : 09:00 A.M to 06:00 P.M IST and 06:30 P.M. to 03:30 A.M. IST Working Days: Monday to Friday (Weekends Off) About ProBill RCM : ProBill RCM is a trusted and rapidly growing Revenue Cycle Management (RCM) company dedicated to optimizing financial outcomes for healthcare providers in the US. We leverage advanced tools, industry best practices, and a client-first philosophy to streamline billing operations, minimize errors, and maximize efficiency. At ProBill RCM, we are committed to bridging the gap between healthcare services and financial clarity, ensuring our clients can focus on patient care while we manage their revenue cycle complexities. Job Summary: The Payment Posting Analyst plays a critical role in the healthcare revenue cycle,ensuring the accurate and efficient posting of all payment activities. This position involves meticulously reviewing and applying payments from various sources, reconciling accounts, and-identifying discrepancies to maintain a healthy revenue flow for our clients. The Payment Posting Analyst will work closely with billing, collections, and finance teams to ensure seamless operations and compliance with industry regulations. Key Responsibilities:  Payment Application: o Review and accurately post electronic and manual payments from insurance carriers, patients, and third-party payers to patient accounts. o Apply contractual adjustments, write-offs, and denials in compliance with payer contracts and organizational policies. o Accurately interpret Explanation of Benefits (EOBs) and Electronic Remittance Advises (ERAs), identifying variances and escalating underpayments or rejections. o Post patient payments and balance daily deposits. o Reconcile checks and lost payments.  Reconciliation & Reporting: o Review daily posting reports to identify discrepancies or errors and correct them promptly. o Assist in updating direct deposits daily and performing comparisons of downloaded files to direct deposits, correcting any discrepancies. o Generate reports on payment posting activities, including payment trends, outstanding balances, and accounts receivable.  Denial Management & Research: o Capture and address denials effectively, adding appropriate ANSI denial codes and comments to ensure necessary appeals and post-payment follow-up. o Investigate the source of unidentified payments to ensure proper application. o Conduct research through payer portals to identify missing remittances. o Identify trends in payment posting issues and suggest corrective actions or process improvements.  Compliance & Communication: o Ensure strict compliance with HIPAA and other federal, state, and payer regulations. o Maintain up-to-date knowledge of payer policies, medical billing terminology, and payment posting best practices. o Communicate effectively with internal billing and collections teams regarding payment trends, anomalies, and payer behavior. o Address client queries promptly and professionally as they relate to payment posting.  Efficiency & Quality: o Maintain zero backlogs and consistently meet daily/weekly productivity targets. o Prioritize and manage workload effectively to meet multiple deadlines. o Participate in reviews as required by company policy. Required Qualifications:  Experience: 1-3 years of experience in payment posting within a medical billing or RCM environment, preferably with US healthcare providers.  Knowledge: o Strong understanding of US healthcare processes, insurance claims, and denials. o In-depth knowledge of EOBs, ERAs, CPT/ICD codes, and payer-specific rules. o Solid understanding of the full revenue cycle process.  Technical Skills: o Proficiency in practice management systems. o Strong PC skills, including familiarity with Windows Operating Systems and Microsoft Office Products (especially Excel). o Experience with electronic payment posting (EPP) systems is a plus.  Soft Skills: o Exceptional numerical accuracy and high attention to detail. o Excellent written and verbal communication skills. o Strong analytical and problem-solving abilities. o Ability to work independently with minimal supervision and as part of a team. o Must be spontaneous and enthusiastic with a positive mindset. o Ability to learn new tasks, remember processes, maintain focus, and make timely decisions. Preferred Qualifications:  Experience with multiple medical specialties (e.g., behavioral health, internal medicine, surgical practices).  Familiarity with reconciliation tools.  Previous experience working in a RCM team. What ProBill RCM Offers:  Competitive salary.  Fixed 5-day work week with weekends off.  A supportive and collaborative work environment encouraging growth and continuous learning.  Opportunity to be part of a rapidly growing organization in the healthcare RCM industry. How to Apply: Interested candidates are invited to send their updated resume to hr@probillrcm.com with the subject line Payment Posting Analyst Application. Job Type: Full-time Pay: ₹30.00 - ₹70,000.00 per month Benefits: Health insurance Leave encashment Paid sick time Paid time off Schedule: Day shift Monday to Friday Rotational shift Supplemental Pay: Performance bonus Work Location: In person

This role is for one of the Weekday's clients Min Experience: 1 years Location: Hyderabad, Chennai, Bengaluru JobType: full-time We are seeking a dedicated and experienced Senior Accounts Receivable (AR) Caller to join our growing healthcare revenue cycle team. The ideal candidate will be responsible for managing the accounts receivable process, with a strong focus on denial management and revenue cycle management (RCM). As a Senior AR Caller, you will play a critical role in improving cash flow, reducing aging AR, and ensuring prompt resolution of claims. This is an excellent opportunity for professionals with a strong understanding of the US healthcare billing process, EOBs, and insurance follow-up protocols. Requirements Key Responsibilities: Conduct outbound calls to insurance companies (payers) to follow up on pending or denied claims. Perform comprehensive analysis of denied or underpaid claims and identify appropriate actions for resolution. Review Explanation of Benefits (EOB), Remittance Advice (RA), and take necessary actions based on denial reason codes. Work on claims in accordance with standard operating procedures, client-specific guidelines, and payer rules. Collaborate with internal teams and clients to escalate unresolved claims and facilitate quicker collections. Maintain up-to-date documentation of account activity in the system and ensure accuracy of follow-up records. Achieve daily/weekly/monthly productivity and quality targets set by the management. Utilize knowledge of HIPAA compliance, CPT/ICD-10 codes, and payer-specific guidelines to ensure best practices are followed. Proactively identify trends in denials and underpayments to support process improvements and reduce future occurrences. Train and mentor junior AR callers when required, providing them with guidance on complex scenarios and payer-specific nuances. Required Skills and Qualifications: Minimum 1 year and up to 8 years of experience in AR calling within the US healthcare RCM industry. Strong understanding of Revenue Cycle Management (RCM) processes, including insurance follow-up, denial management, and payment posting. Hands-on experience working with healthcare billing systems and claims management platforms. In-depth knowledge of insurance payers (Medicare, Medicaid, Commercial Insurers), claim lifecycle, and denial codes. Excellent communication skills (verbal and written) and ability to interact with insurance representatives professionally. Strong analytical and problem-solving abilities to assess complex claim issues and recommend effective solutions. Proficient in Microsoft Office tools and medical billing software (e.g., EPIC, Athena, eClinicalWorks, Kareo, or similar). Ability to work independently and as part of a team in a fast-paced environment. Preferred Qualifications: Prior experience working in night shifts or US time zones. Certification in Medical Billing or RCM is a plus. Experience with end-to-end RCM process will be an added advantage Show more Show less

This role is for one of the Weekday's clients Min Experience: 1 years Location: Hyderabad, Chennai, Bengaluru JobType: full-time We are seeking a dedicated and experienced Senior Accounts Receivable (AR) Caller to join our growing healthcare revenue cycle team. The ideal candidate will be responsible for managing the accounts receivable process, with a strong focus on denial management and revenue cycle management (RCM). As a Senior AR Caller, you will play a critical role in improving cash flow, reducing aging AR, and ensuring prompt resolution of claims. This is an excellent opportunity for professionals with a strong understanding of the US healthcare billing process, EOBs, and insurance follow-up protocols. Requirements Key Responsibilities: Conduct outbound calls to insurance companies (payers) to follow up on pending or denied claims. Perform comprehensive analysis of denied or underpaid claims and identify appropriate actions for resolution. Review Explanation of Benefits (EOB), Remittance Advice (RA), and take necessary actions based on denial reason codes. Work on claims in accordance with standard operating procedures, client-specific guidelines, and payer rules. Collaborate with internal teams and clients to escalate unresolved claims and facilitate quicker collections. Maintain up-to-date documentation of account activity in the system and ensure accuracy of follow-up records. Achieve daily/weekly/monthly productivity and quality targets set by the management. Utilize knowledge of HIPAA compliance, CPT/ICD-10 codes, and payer-specific guidelines to ensure best practices are followed. Proactively identify trends in denials and underpayments to support process improvements and reduce future occurrences. Train and mentor junior AR callers when required, providing them with guidance on complex scenarios and payer-specific nuances. Required Skills and Qualifications: Minimum 1 year and up to 8 years of experience in AR calling within the US healthcare RCM industry. Strong understanding of Revenue Cycle Management (RCM) processes, including insurance follow-up, denial management, and payment posting. Hands-on experience working with healthcare billing systems and claims management platforms. In-depth knowledge of insurance payers (Medicare, Medicaid, Commercial Insurers), claim lifecycle, and denial codes. Excellent communication skills (verbal and written) and ability to interact with insurance representatives professionally. Strong analytical and problem-solving abilities to assess complex claim issues and recommend effective solutions. Proficient in Microsoft Office tools and medical billing software (e.g., EPIC, Athena, eClinicalWorks, Kareo, or similar). Ability to work independently and as part of a team in a fast-paced environment. Preferred Qualifications: Prior experience working in night shifts or US time zones. Certification in Medical Billing or RCM is a plus. Experience with end-to-end RCM process will be an added advantage Show more Show less

This role is for one of the Weekday's clients Min Experience: 1 years Location: Hyderabad, Chennai, Bengaluru JobType: full-time We are seeking a dedicated and experienced Senior Accounts Receivable (AR) Caller to join our growing healthcare revenue cycle team. The ideal candidate will be responsible for managing the accounts receivable process, with a strong focus on denial management and revenue cycle management (RCM). As a Senior AR Caller, you will play a critical role in improving cash flow, reducing aging AR, and ensuring prompt resolution of claims. This is an excellent opportunity for professionals with a strong understanding of the US healthcare billing process, EOBs, and insurance follow-up protocols. Requirements Key Responsibilities: Conduct outbound calls to insurance companies (payers) to follow up on pending or denied claims. Perform comprehensive analysis of denied or underpaid claims and identify appropriate actions for resolution. Review Explanation of Benefits (EOB), Remittance Advice (RA), and take necessary actions based on denial reason codes. Work on claims in accordance with standard operating procedures, client-specific guidelines, and payer rules. Collaborate with internal teams and clients to escalate unresolved claims and facilitate quicker collections. Maintain up-to-date documentation of account activity in the system and ensure accuracy of follow-up records. Achieve daily/weekly/monthly productivity and quality targets set by the management. Utilize knowledge of HIPAA compliance, CPT/ICD-10 codes, and payer-specific guidelines to ensure best practices are followed. Proactively identify trends in denials and underpayments to support process improvements and reduce future occurrences. Train and mentor junior AR callers when required, providing them with guidance on complex scenarios and payer-specific nuances. Required Skills and Qualifications: Minimum 1 year and up to 8 years of experience in AR calling within the US healthcare RCM industry. Strong understanding of Revenue Cycle Management (RCM) processes, including insurance follow-up, denial management, and payment posting. Hands-on experience working with healthcare billing systems and claims management platforms. In-depth knowledge of insurance payers (Medicare, Medicaid, Commercial Insurers), claim lifecycle, and denial codes. Excellent communication skills (verbal and written) and ability to interact with insurance representatives professionally. Strong analytical and problem-solving abilities to assess complex claim issues and recommend effective solutions. Proficient in Microsoft Office tools and medical billing software (e.g., EPIC, Athena, eClinicalWorks, Kareo, or similar). Ability to work independently and as part of a team in a fast-paced environment. Preferred Qualifications: Prior experience working in night shifts or US time zones. Certification in Medical Billing or RCM is a plus. Experience with end-to-end RCM process will be an added advantage Show more Show less

We are seeking an experienced Data Modeler/Lead with deep expertise in health plan data models and enterprise data warehousing to drive our healthcare analytics and reporting initiatives. The candidate should have hands-on experience with modern data platforms and a strong understanding of healthcare industry data standards. About the Role The candidate will be responsible for leading data modeling initiatives and ensuring compliance with healthcare regulations while collaborating with various stakeholders to translate business requirements into technical solutions. Responsibilities: Data Architecture & Modeling Design and implement comprehensive data models for health plan operations, including member enrollment, claims processing, provider networks, and medical management. Develop logical and physical data models that support analytical and regulatory reporting requirements (HEDIS, Stars, MLR, risk adjustment). Create and maintain data lineage documentation and data dictionaries for healthcare datasets. Establish data modeling standards and best practices across the organization. Technical Leadership Lead data warehousing initiatives using modern platforms like Databricks or traditional ETL tools like Informatica. Architect scalable data solutions that handle large volumes of healthcare transactional data. Collaborate with data engineers to optimize data pipelines and ensure data quality. Healthcare Domain Expertise Apply deep knowledge of health plan operations, medical coding (ICD-10, CPT, HCPCS), and healthcare data standards (HL7, FHIR, X12 EDI). Design data models that support analytical, reporting and AI/ML needs. Ensure compliance with healthcare regulations including HIPAA/PHI, and state insurance regulations. Partner with business stakeholders to translate healthcare business requirements into technical data solutions. Data Governance & Quality Implement data governance frameworks specific to healthcare data privacy and security requirements. Establish data quality monitoring and validation processes for critical health plan metrics. Lead efforts to standardize healthcare data definitions across multiple systems and data sources. Required Qualifications: Technical Skills 10+ years of experience in data modeling with at least 4 years focused on healthcare/health plan data. Expert-level proficiency in dimensional modeling, data vault methodology, or other enterprise data modeling approaches. Hands-on experience with Informatica PowerCenter/IICS or Databricks platform for large-scale data processing. Strong SQL skills and experience with Oracle Exadata and cloud data warehouses (Databricks). Proficiency with data modeling tools (Hackolade, ERwin, or similar). Healthcare Industry Knowledge Deep understanding of health plan data structures including claims, eligibility, provider data, and pharmacy data. Experience with healthcare data standards and medical coding systems. Knowledge of regulatory reporting requirements (HEDIS, Medicare Stars, MLR reporting, risk adjustment). Familiarity with healthcare interoperability standards (HL7 FHIR, X12 EDI). Leadership & Communication Proven track record of leading data modeling projects in complex healthcare environments. Strong analytical and problem-solving skills with ability to work with ambiguous requirements. Excellent communication skills with ability to explain technical concepts to business stakeholders. Experience mentoring team members and establishing technical standards. Preferred Qualifications Experience with Medicare Advantage, Medicaid, or Commercial health plan operations. Cloud platform certifications (AWS, Azure, or GCP). Experience with real-time data streaming and modern data lake architectures. Knowledge of machine learning applications in healthcare analytics. Previous experience in a lead or architect role within healthcare organizations. Show more Show less

Job Title: Radiology Medical Coder Years of Experience: 1 year No of openings: 15 Notice period: Immediate to 15days Job Summary: We are seeking detail-oriented and experienced Radiology Medical Coders . The ideal candidate will accurately assign CPT, ICD-10-CM, Modifiers and HCPCS codes for diagnostic and Therapeutic radiology procedures, ensuring compliance with federal regulations, payer-specific requirements, and internal quality standards. Key Responsibilities: Review and analyze radiology reports to assign accurate diagnosis and procedure codes. Ensure coding compliance in accordance with ACR, CMS, and payer guidelines. Code a variety of radiology modalities including X-ray, CT, MRI, Ultrasound, Nuclear Medicine, and Radiation oncology. Collaborate with radiologists, billing staff, and auditors to resolve coding discrepancies. Stay updated with coding guidelines, NCCI edits, and regulatory changes. Meet daily productivity and accuracy benchmarks as established by the department. Assist in internal and external audits as needed. Qualifications: Certified Professional Coder (CPC) Minimum of [1- 2] years of hands-on experience in radiology coding (IR preferred). MIPS Coding is Mandatory. In-depth knowledge of CPT®, ICD-10-CM, and HCPCS Level II codes Familiarity with payer-specific rules and LCD/NCD policies. Show more Show less

Role:- Outpatient Coding Specialist Notice period:- Immediate Joiners/20 days Experience :- * 2+ Outpatient coding experience required * US Physician , Clinic (ambulatory ,internal medicine, general ,medicine, Orthopaedic ) healthcare experience is required Location:- Remote Job Description:- Job Specific Accountabilities:  Contributes to the Coding Team efforts.  Assign accurate diagnosis and procedure codes using ICD-10-CM/PCS to inpatient records.  Assign diagnosis and procedure codes to ICD-10-CM/PCS and CPT to outpatient surgery records.  Utilize coding guidelines set up by government agencies dealing with the coding of health information.  Accurately enter abstract information into the computer on inpatient and outpatient records.  Participation in educational meetings as directed.  Participation in committees as needed.  Maintain a standard of productivity that consistently meets or exceeds 95% productivity.  Assist the Medical & Dental staff, hospital employees and others in a courteous and helpful manner.  Maintain patient confidentiality at all times.  Follow the code of Ethics and the Standards of Ethical Coding developed by the American Health Information Management Association. The ultimate customer is always the patient. However, you provide services to other internal and external customers. Identify those other primary customers to whom you provide service. Customers for his position would include co-workers, physicians, patient’s family members, volunteer’s, vendors, outside agencies or organizations that may have contact with the office in addition to patients. Certification/Registration - RHIT, CCS, CPC The ED/OP Coding Specialist must accurately code and abstract diagnoses and procedures occurring during the patient’s episode of care, in a timely manner, in order for the facility to receive proper reimbursement. Show more Show less

Omega Healthcare Management Services Private Limited TAMIL NADU Posted On 16 Jun 2025 End Date 30 Jun 2025 Required Experience 3 - 5 Years Basic Section No. Of Openings 1 Grade 1D Designation Quality Control Analyst - AR Closing Date 30 Jun 2025 Organisational Country IN State TAMIL NADU City CHENNAI Location Chennai-I Skills Skill QUALITY CONTROL CPT ICD-9 HIPAA EMR HEALTHCARE MEDICAL BILLING RADIOLOGY HCPCS MEDICINE REVENUE CYCLE PUBLIC RELATIONS CONTRACT NEGOTIATION BPO TEAM BUILDING ACCOUNTS RECEIVABLE PROCESS IMPROVEMENT AUDITING Education Qualification No data available CERTIFICATION No data available Job Description Role Description Overview: The QC is accountable to manage day to day activities of Coding and Ensuring that project related quality processes are followed by associates, client specific metrics and internal metrics are achieved, provide coaching to employees, track and trend data for improvement Responsibility Areas: Participate in client calls and understand the quality requirements both from process perspective and for targets Identify a method to achieve the quality targets and implement the same in consultation with operations manager / Team Manager Identify errors with high Inspection efficiency Provide face to face feedback and also send emails with the type of errors etc. on daily basis as per protocol Ensure correction of the error by the respective Operations associate Coach employees to minimize errors and improve performance Provide inputs to the training team on common mistakes made to enhance training curriculum Test files/batches for new clients/processes to be processed as part of familiarization Generation of QA reports on a daily basis Attainment of Internal & External SLA as per Process Defined. Meet and exceed inspection efficiency score, calibration score, knowledge and skills score, inspection productivity rate and any other appropriate metrics Record identified errors. This is an organizational record & can be used by the organization as it deems fit Strict adherence to the company policies and procedures. Extensive Quality experience Audits, Coaching & training as per process defined. Min of 1.5 Yrs of Professional and Relevant Experience Sound knowledge in Healthcare concept. Critical problem solving and issue resolution Must have Good Product and Process Knowledge Must have good analytical and judgmental skills Quality Feedback/Refresher sessions Prepare and Maintain Quality status reports

Job Description As a Medical Coder, you will play a critical role in the healthcare industry by translating healthcare services and diagnoses into standardized, universally accepted codes. These codes are then used for billing, insurance purposes, and maintaining accurate healthcare records. The position requires a sharp eye for detail, the ability to accurately match medical diagnosis and treatments with the correct codes, and extensive knowledge of medical terminology and coding systems such as ICD-10, CPT, and HCPCS. Working as a Medical Coder means you will be an integral part of the healthcare team, contributing to the maintenance of data integrity and the smooth operation of healthcare facilities. Your work ensures that healthcare providers are reimbursed accurately and promptly, making sure that all financial transactions related to patient care flow smoothly. Responsibilities Accurately translate medical procedures and diagnoses into standardized codes for healthcare records. Ensure compliance with all local, state, and federal coding guidelines and regulations. Collaborate with healthcare practitioners to clarify diagnoses, procedures, and medical record details. Review patient records for accuracy, completeness, and timeliness of coding entries. Utilize coding software systems to maximize efficiency and accuracy in the coding process. Maintain the confidentiality of sensitive patient and organizational healthcare information. Regularly update personal knowledge of medical terminology and industry coding guidelines. Audit coded data for potential errors and make necessary amendments. Generate accurate reports and data analysis from coded data as requested. Provide feedback and training to healthcare team members on proper documentation and coding practices. Participate in professional development opportunities to stay current with coding standards. Communicate effectively with other departments to resolve coding-related queries and issues. Requirements Certified Professional Coder (CPC) or equivalent certification is preferred. Strong knowledge of ICD-10, CPT, and HCPCS coding systems and guidelines. Minimum of one year of experience in a clinical or medical setting preferred. Exceptional attention to detail with a focus on high accuracy in coding work. Proficient with healthcare software, coding systems, and electronic medical records. Excellent communication skills for interaction with healthcare professionals and staff. Ability to work independently in a fast-paced environment with minimal supervision. Job Details Role Level: Mid-Level Work Type: Full-Time Country: India City: Chennai Company Website: https://www.talentmate.com Job Function: Medical Coding & Billing Company Industry/ Sector: Recruitment & Staffing What We Offer About The Company Searching, interviewing and hiring are all part of the professional life. The TALENTMATE Portal idea is to fill and help professionals doing one of them by bringing together the requisites under One Roof. Whether you're hunting for your Next Job Opportunity or Looking for Potential Employers, we're here to lend you a Helping Hand. Report Similar Jobs Client Service Associate Talentmate Senior Project Manager Talentmate Sales Manager - SAAS Talentmate Concierge Associate Talentmate IT & System Administrator Talentmate Customer Support Engineer Talentmate Disclaimer: talentmate.com is only a platform to bring jobseekers & employers together. Applicants are advised to research the bonafides of the prospective employer independently. We do NOT endorse any requests for money payments and strictly advice against sharing personal or bank related information. We also recommend you visit Security Advice for more information. If you suspect any fraud or malpractice, email us at abuse@talentmate.com. Show more Show less

Location : Remote (India-based preferred) Type : Full-time | US Client Support Experience : 10+ Years in Healthcare Finance, RCM, and Denials Management Preferred Qualification: Experience working with cardiology practices or specialty clinics in the US. Certified Healthcare Financial Professional (CHFP) – HFMA • Certified Professional Coder (CPC) – AAPC • Certified Revenue Cycle Representative (CRCR) – HFMA • Six Sigma or Lean Certification Work Hours : Must be available during US Pacific Standard Time (PST) hours About Orchestrate Medical Orchestrate Medical is redefining medical billing and Revenue Cycle Management (RCM) for small to medium-sized practices across the US. We bring together deep industry expertise and AI-driven technology to deliver accurate, compliant, and cost-effective billing support. Our clients rely on us to streamline operations, maximize revenue, and deliver real-time insights. We are growing rapidly and currently hiring a senior-level financial analyst to support our premier client, a leading cardiology practice. Role Overview We are seeking a seasoned Financial Analyst with at least 10 years of experience in medical financial analysis, AP billing , and denials management . This position will play a pivotal role in analyzing performance, identifying financial risks and revenue opportunities, and driving data-backed recommendations across the RCM lifecycle for a large Cardiology Practice. This is a client-facing analytical role where precision, insight, and strategic recommendations will directly impact business performance. Key Responsibilities Analyze financial performance across service lines, providers, and payer contracts using SQL and Power BI dashboards. Prepare monthly and quarterly financial summaries: profitability trends, denial rates, AR aging, reimbursement performance, and scenario planning. Lead deep-dive analysis into AP billing issues and denial root causes , recommending corrective actions for collections improvement. Collaborate with operations and billing teams to align financial strategies with workflow processes and compliance standards. Monitor KPIs like collections ratio, denial rate, revenue per visit, and net collections rate; identify outliers and trend deviations. Build forecasting models for best-case and worst-case scenarios using historical and real-time data inputs. Present insights and strategies directly to US-based leadership + internal stakeholders) on a regular cadence. Qualifications Minimum 10 years of US based RCM environment . Strong domain expertise in Analytics, Accounts Payable (AP) billing , denial management , and compliance tracking . Strong experience with SQL , Power BI , and Excel-based financial modeling. Proven track record of delivering executive-level dashboards and performance insights. Understanding of CPT/ICD-10 coding and payer-specific denial patterns is a strong plus. Strong communication skills with the ability to explain technical concepts to clinical and non-technical audiences. Bachelor's or Master’s degree in Finance, Healthcare Administration, or a related field. Certifications Preferred Certified Healthcare Financial Professional (CHFP) – HFMA Certified Professional Coder (CPC) – AAPC Certified Revenue Cycle Representative (CRCR) – HFMA Six Sigma or Lean Certification (preferred for process improvement expertise) Preferred Attributes Experience working with cardiology practices or specialty clinics in the US. Familiarity with Athenahealth or similar EHR systems. Must be able to work during US Pacific Standard Time (PST) hours to collaborate with US-based clients and internal teams. High attention to detail and proactive approach to identifying and resolving revenue leakage. Why Join Us? Work with a visionary leadership team transforming healthcare billing with AI and automation. Be a strategic partner to a respected cardiology group with high operational standards. Fast-track your career through ownership, autonomy, and impact on high-value deliverables. Remote-first environment with global exposure. How to Apply Please send your resume and a brief cover letter outlining your healthcare financial analysis experience, particularly related to AP billing and denials, to [careers@orchestrate.com] or apply via [LinkedIn/Job Portal Link]. Show more Show less

Company Description We at Vitraya, quietly building something at the intersection of AI, insurance, and healthcare claims, Hospitals lose thousands of crores every year due to denied or delayed claims and with increasing govt spending, the figure going to be crazy high. As a technology-first company, we're solving critical challenges in the Indian healthcare market, including lack of transparency, high rejection rates, and inefficient claims processing. Our mission is to transform how hospitals & insurance manage their claims processing, enabling them to focus on what matters most—patient care & experience Role Description You will be the clinical cornerstone of our revenue cycle operations, leading a specialized team of medical experts who bridge the gap between clinical documentation and financial outcomes. You will harness your medical expertise and leadership abilities to ensure clinical accuracy in claims processing, minimize denials through expert medical validation by helping us build cutting edge tools and services, and build trust-based relationships with healthcare providers, insurance partners, and government schemes. This role demands a unique blend of clinical knowledge, operational leadership, and technological adaptability—all while embodying our core values of empathy and compassion. You'll be instrumental in transforming how hospitals in India manage their claims, ultimately improving healthcare accessibility and financial transparency for patients. This is a role for the curious and forward-thinking medical professional who is excited about how AI and technology are reshaping healthcare operations and wants to be at the forefront of this transformation. Key Responsibilities Clinical Leadership & Team Management •Lead, mentor, and develop a high-performing team of medical experts •Establish clinical standards and protocols for claim validation, documentation review, and denial prevention •Oversee the clinical training and continuous education of medical experts, ensuring they stay current with coding guidelines and medical necessity criteria •Foster a culture of clinical excellence, attention to detail, and continuous improvement •Manage team performance through data-driven metrics while maintaining quality standards •Coordinate seamlessly between on-ground medical experts and remote team members across our locations •Autonomously build and scale your team with minimal oversight, demonstrating your ability as a self-starter and natural leader Clinical Claim Validation & Denial Management •Serve as the ultimate clinical authority for complex claim reviews, providing expert medical opinions on challenging cases •Develop and implement clinical documentation improvement strategies to prevent denials and optimize reimbursement •Collaborate with hospital clinical teams to resolve documentation gaps and clinical queries •Lead the clinical aspects of appeals management, providing compelling medical justification for overturning denials •Establish trusted relationships with medical reviewers at insurance companies and government schemes •Conduct regular clinical audits to identify patterns in denials and implement preventive measures Technology Integration & Innovation •Partner with our technology team to enhance our AI prediction engine for identifying potential denial flags •Provide clinical expertise for the development and refinement of our AI Engines and LLMs •Champion the adoption of AI-assisted clinical documentation review tools among your team •Develop clinical decision support frameworks that can be integrated into our technology platform •Identify opportunities for automation in clinical validation processes while maintaining quality and compliance •Translate complex clinical concepts into structured data elements that can be leveraged by our technology systems •Demonstrate curiosity and enthusiasm for how AI is reshaping medical claim processing, contributing ideas for technological innovation Market-Facing & Thought Leadership •Serve as a spokesperson for us at industry events, webinars, and conferences •Participate in sales presentations to showcase clinical expertise and build credibility with potential hospital partners •Create and deliver educational content on best practices in clinical documentation and denial prevention •Conduct webinars and training sessions for hospital partners on optimizing clinical documentation for claims •Contribute to thought leadership content, including articles, white papers, and case studies •Represent our brand clinical perspective in media interactions and PR opportunities •Build relationships with key opinion leaders in the healthcare industry Qualifications & Experience Required Qualifications •Medical degree (MBBS, BDS, BHMS, or equivalent) with valid registration •7+ years of clinical experience, with at least 3 years in healthcare administration, revenue cycle management, or related fields •Proven experience managing teams of medical professionals in a performance-driven environment •Strong understanding of medical coding, clinical documentation requirements, and healthcare reimbursement •Experience with both government healthcare schemes (MAA, PMJAY, RGHS, CGHS) and private insurance in India •Demonstrated ability to translate clinical knowledge into operational excellence •Excellent communication skills with the ability to explain complex medical concepts to diverse stakeholders •Demonstrated ability to operate autonomously and drive results with minimal supervision Preferred Qualifications •Additional qualifications in healthcare management, health informatics, or related fields •Experience with AI-assisted clinical documentation or coding systems •Background in clinical denial management and appeals •Experience working with multiple medical specialties and case types •Knowledge of healthcare technology platforms and electronic medical records •History of implementing clinical quality improvement initiatives •Experience in startup or high-growth environments •Public speaking experience, including presentations, webinars, or conference talks •Experience participating in sales processes or business development activities Core Competencies Clinical & Technical Expertise •Deep understanding of clinical documentation requirements across specialties •Knowledge of medical necessity criteria and evidence-based practice •Familiarity with ICD-10, CPT/HCPCS coding principles •Understanding of healthcare reimbursement methodologies •Ability to leverage technology for clinical decision support •Aptitude for translating clinical knowledge into operational processes •Curiosity and enthusiasm for AI and emerging technologies in healthcare Show more Show less

Description The Central Programs Team, India (CPT India) leads cross-functional projects that requires collaboration and partnership with Amazon businesses, geographical units and technical subject matter experts (SMEs). The projects are focused on initiatives to continually reduce risks and improve network WHS standards and procedures. Individuals gather business requirements, document functional and design specifications, identify appropriate resources needed, assemble the right project team, assign individual responsibilities and develop the milestones and launch schedules to ensure timely and successful delivery of the project. The team members measure and report progress, anticipate and resolve bottlenecks, provide escalation management, anticipate and make tradeoffs, and balance the business needs with the technical constraints. This a program management role responsible for executing per direction, the management of the WW WHS programs (standards, procedures, best practices) development, training and continuous improvement projects. The role involves hands-on work in the areas of understanding stakeholder needs and expectations, WHS regulatory research, global stakeholder engagement, data analytics and document technical writing. The candidate must be a self-starter and detail-oriented. They must be an effective communicator and send clear, concise and consistent messages, both verbally and in writing. Key job responsibilities Program/Process Improvement, Project Management Clearly and timely communicate findings, determinations, and recommendations to compliance management and business partners, both at periodic intervals and as needed regarding escalated or high-risk compliance issues. Guide management in the development/review of applicable policies, procedures and business practices. Engage in frequent written and verbal communication with management and business partners to accomplish goals. Execute and drive audits to completion per SOP. This includes drafting audit reports, stakeholder reviews of audit reports, finalizing and tracking audit reports in database and tracking issues in system (and SIM/TT management). Owns weekly/monthly reports and metrics. Identifies gaps in audit programs and processes and escalates to manager. Follows confidentiality rules with the documents reviewed. Drafts documents and revisions on audit reports per manager direction. Performs deep dive analysis/research on data/information/literature and creates recommendations/corrective actions based on identified deviations and recommends appropriate solutions. Earns trust of peers by understanding audit processes and programs. Makes recommendations to managers for input into roadmap strategic discussions and continuous improvement projects to drive program efficiencies. Basic Qualifications Bachelor’s degree or equivalent from an accredited university Minimum 2 years relevant program management experience Analytical skills with experience using Excel (analysis using aggregate functions and pivot table) Good communication skills both verbal and writing (Ability to communicate clear and coherent narratives) Preferred Qualifications Advanced Excel (Macros/VBA) Experience with Stakeholder Management across Geographies Program/Project Management Certification -Six Sigma Certification Knowledge of visualization tools like QuickSight, Tableau etc. Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit https://amazon.jobs/content/en/how-we-hire/accommodations for more information. If the country/region you’re applying in isn’t listed, please contact your Recruiting Partner. Company - ADCI - Karnataka Job ID: A2940255 Show more Show less

We are Hiring!!! Designation : AR Caller Experience : Minimum 1 year - 2yr (AR Caller ). Salary :Upto 4.5 LPA Working days : 5 days of working. Shift : Night shift Skill Set : Excellent English communication Location : lanco hills, Manikonda Job Criteria : * Should have overall experience of 1 to 4 years of RCMS Experience. * Good analytical skills required. * Good communication skills. Should be flexible to work from office . * Should be flexible to learn / explore new opportunities. Candidate should have basic understanding of : 1) Claim form 1500 Physician RCM Background Provider side Coding tools CCI, MCKesson 2) Specialties - Ex: Cardiology, radiology, gastro, peds, ortho, medicine, emergency medicine, surgery etc., ecommerce etc., 3) CPT range & Modifiers Should be voice based only Role Definition : Primary responsibility of a Sr. Consultant would be achieving daily KRA’s assigned to him / her not limited to following – 1) Production – Review of claims to liquidate and resolve outstanding AR or denials. 2) Quality - Complete Production with Minimal deviation or 3) TOS – Need to adhere to shift schedule, productive time on system. Interested candidates can contact HR - 7358756477 Job Type: Full-time Pay: ₹28,000.00 - ₹38,000.00 per month Benefits: Provident Fund Schedule: Night shift Supplemental Pay: Performance bonus Application Question(s): How many years of Experience do you have as a AR Caller? Can you come for a Walk - In Interview to Hyderabad Manikonda Location? Are you a Immediate joiner? Experience: AR Caller : 1 year (Required) Work Location: In person Speak with the employer +91 7358756477