Welcome Back

Google icon Sign in with Google
OR
I agree to abide by Pharmadaily Terms of Service and its Privacy Policy

Create Account

Google icon Sign up with Google
OR
By signing up, you agree to our Terms of Service and Privacy Policy
Instagram
youtube
Facebook

Medical Coder

Clario
clario
1-4 years
preferred by company
Bangalore, India
1 May 13, 2026
Job Description
Job Type: Full Time Education: B.Sc/M.Sc/M.Pharma/B.Pharma/Life Sciences Skills: Data Analysis, Document Management, Life Science, Regulatory Compliance, Waterfall Model, Environment, Experiments Design, Health And Safety (Ehs), Laboratory Equipment, Manufacturing Process, Materials Science, Process Simulation, Sop (Standard Operating Procedure), Technical Writing, Wat, GCP guidelines, gmp knowledge, HSE Knowledge , Logistics and Transportation Management, Master Data, Operational Excellence, Sap Erp, supply chain management, Supply Planning, Warehouse Management, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing

Job Title: Medical Coder

Location: Bangalore, Karnataka, India
Job Type: Full-Time
Experience Required: 1–4+ Years (Freshers generally not eligible unless certified with relevant internship experience)
Industry: Healthcare Operations / Medical Coding / Revenue Cycle Management / Health Information Management / Healthcare Analytics
Department: Medical Coding / Clinical Documentation / Risk Adjustment Operations

About the Role
We are seeking a detail-oriented and analytical Medical Coder to support healthcare coding accuracy, risk adjustment documentation, and clinical data quality initiatives within a fast-paced healthcare operations environment. This role is ideal for professionals with expertise in medical coding, CMS HCC coding, HEDIS coding, CPT coding, provider query management, and healthcare documentation review.

The ideal candidate will review clinical records, assign accurate diagnosis and procedure codes, support risk adjustment workflows, and ensure compliance with coding standards, reimbursement guidelines, and healthcare regulatory requirements.

This opportunity is highly suited for professionals seeking growth in medical coding, healthcare analytics, and value-based care documentation operations.

Key Responsibilities

Medical Coding & Clinical Documentation Review

  • Review patient medical records to assign accurate diagnosis, procedure, and exclusion codes based on clinical documentation and healthcare services rendered.
  • Verify coding accuracy, specificity, completeness, and appropriateness according to healthcare coding guidelines and reimbursement standards.
  • Interpret clinical documentation using knowledge of anatomy, physiology, disease processes, and healthcare terminology.

CMS HCC Risk Adjustment Coding

  • Review medical records to identify applicable CMS Hierarchical Condition Category (CMS-HCC) diagnosis codes for risk adjustment documentation.
  • Ensure complete capture of chronic conditions and risk-adjustable diagnoses impacting reimbursement and quality reporting.
  • Support accurate risk adjustment coding aligned with value-based healthcare documentation requirements.

HEDIS & CPT Coding Support

  • Identify appropriate HEDIS exclusion codes not mapped within CMS-HCC models.
  • Assign accurate CPT II procedure codes based on documented clinical care and performance measures.
  • Support quality reporting initiatives linked to healthcare performance metrics and compliance standards.

Coding Systems & Documentation Management

  • Utilize coding software platforms, coding references, and healthcare documentation systems to identify and validate codes.
  • Complete accurate system entries related to claims, encounters, coding documentation, and operational tracking.
  • Maintain comprehensive tracking tools to monitor coding activities, productivity, and completion timelines.

Provider Query & Documentation Clarification

  • Perform AHIMA / ACDIS-compliant provider queries when clinical documentation clarification is required.
  • Review provider responses and make final coding determinations based on updated documentation.
  • Ensure compliant provider communication practices supporting documentation integrity.

Quality Assurance & Compliance

  • Maintain compliance with medical coding guidelines, CMS regulations, reimbursement policies, documentation standards, and healthcare audit expectations.
  • Stay updated on coding changes, regulatory updates, payer rules, and evolving healthcare documentation requirements.
  • Participate in coding audits, quality reviews, compliance monitoring, and special project assessments.

Training, Mentorship & Operational Support

  • Participate in ongoing coding education, certification updates, and internal training programs.
  • Support knowledge sharing and mentor team members to improve coding quality and operational consistency.
  • Escalate operational barriers, workflow concerns, or documentation issues to leadership proactively.

Required Qualifications

  • Bachelor’s degree in Life Sciences, Healthcare, Nursing, Pharmacy, Biomedical Sciences, Health Information Management, or related disciplines preferred.
  • 1–4+ years of relevant experience in medical coding, healthcare documentation review, risk adjustment coding, or healthcare operations.
  • Strong expertise in CMS HCC coding, ICD-10-CM, CPT/CPT II coding, HEDIS measures, provider documentation review, and healthcare coding compliance.
  • Working knowledge of AHIMA / ACDIS provider query standards preferred.
  • Strong understanding of anatomy, physiology, disease processes, and clinical terminology.
  • Experience with coding software tools, EMR systems, and healthcare documentation platforms.
  • Excellent attention to detail, analytical thinking, documentation review accuracy, and problem-solving capabilities.
  • Strong written and verbal communication skills.

Preferred Skills

  • Medical coding
  • CMS HCC coding
  • ICD-10-CM
  • CPT / CPT II coding
  • HEDIS coding
  • Risk adjustment documentation
  • Provider query management
  • Clinical documentation improvement
  • Healthcare compliance
  • Coding audits
  • Revenue cycle support
  • Health information management