Senior Medical Coding Analyst
Location: Chennai, India
Work Model: Hybrid
Employment Type: Full Time
Job Overview
The Senior Medical Coding Analyst is responsible for ensuring accurate, compliant, and efficient medical coding operations that support revenue cycle performance. The role involves applying multi-specialty coding expertise across Evaluation & Management (E/M), Surgery, Radiology, and Denial Management to improve coding accuracy, reduce claim denials, support root cause analysis, and drive continuous process improvement.
The position plays a critical role in maintaining coding quality, supporting operational reporting, and enhancing healthcare revenue cycle outcomes.
Summary of Responsibilities
Medical Coding Operations
Apply CPC, CCS, or equivalent coding standards to accurately code assigned medical records.
Perform coding activities across multiple specialties, including:
E/M Outpatient Coding
E/M Inpatient Coding
Surgery Coding
Radiology Coding
Ensure coding selections comply with documentation requirements and coding guidelines.
Maintain high levels of coding accuracy, quality, and productivity.
Denial Prevention & Resolution
Perform denial-focused coding reviews to identify coding-related drivers of claim denials.
Support denial prevention initiatives through accurate coding practices.
Assist in coding rework and claim correction workflows.
Collaborate with internal stakeholders to resolve coding discrepancies and improve claim outcomes.
Quality Review & Root Cause Analysis
Analyze coding errors and operational outcomes.
Conduct root cause analysis (RCA) for coding-related issues.
Identify recurring coding trends and opportunities for improvement.
Support corrective actions to improve coding quality and reduce rework.
Documentation & Compliance
Validate clinical documentation sufficiency and coding accuracy.
Ensure coding decisions align with:
Medical Documentation
Coding Guidelines
Compliance Requirements
Maintain audit-ready coding documentation and quality records.
Document coding rationale, audit findings, and quality observations within designated systems.
AI-Assisted Coding Support
Utilize AI-enabled coding assistance tools where available.
Review AI-generated coding suggestions and documentation summaries.
Apply professional CPC/CCS judgment to ensure final coding accuracy and compliance.
Quality Improvement & Reporting
Support quality audits and coding review activities.
Participate in quality calibration sessions to maintain coding consistency.
Contribute to quality trend analysis and operational reporting.
Assist in maintaining coding quality metrics and performance dashboards.
Support initiatives focused on reducing denials and coding rework.
Training & Knowledge Sharing
Share coding insights and lessons learned from audits and denial analyses.
Assist in clarifying coding guidelines and providing real-world coding examples.
Support education and feedback initiatives across coding teams.
Participate in continuous learning and process improvement activities.
Perform additional duties as assigned.
Qualifications (Minimum Required)
CPC (Certified Professional Coder), CCS (Certified Coding Specialist), or equivalent coding certification.
Bachelor's Degree in:
Life Sciences
Healthcare Administration
Medical Sciences
Nursing
Pharmacy
Related Healthcare Discipline
Experience (Minimum Required)
3 to 6 years of experience in:
Medical Coding
Healthcare Revenue Cycle Management (RCM)
Coding Quality Operations
Strong experience in:
E/M Outpatient Coding
E/M Inpatient Coding
Surgery Coding
Radiology Coding
Experience handling:
Coding Audits
Denial Coding
Claim Rework Activities
Coding Quality Reviews
Strong understanding of:
CPT Coding
ICD Coding
HCPCS Coding
Coding Compliance Standards
Revenue Cycle Processes
Experience performing:
Root Cause Analysis
Quality Assessments
Coding Error Reviews
Ability to work effectively in a hybrid work environment.
Preferred Qualifications
Healthcare Revenue Cycle Management (RCM) experience.
Experience with coding audit programs.
Knowledge of payer denial management processes.
Exposure to AI-assisted coding tools and technologies.
Experience contributing to quality improvement initiatives.
Knowledge of medical billing and claims processing workflows.
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