27 Pathology Director jobs in India

• Analyze medical records and documentation to identify services provided during patient evaluations and management

• Assign appropriate E&M codes based on the level of service rendered and in accordance with coding guidelines and regulations (e.g., CPT, ICD-10-CM, HCPCS)

• Ensure coding accuracy and compliance with coding standards, including documentation requirements for various E&M levels

• Stay up-to-date with relevant coding guidelines, including updates from regulatory bodies (e.g., Centers for Medicare and Medicaid Services, American Medical Association)

• Adhere to coding regulations, such as HIPAA (Health Insurance Portability and Accountability Act) guidelines, to ensure patient privacy and confidentiality

• Follow coding best practices and maintain a thorough understanding of coding conventions and principles

• Collaborate with healthcare professionals, including physicians, nurses, and other staff members, to obtain necessary information for coding purposes

• Communicate with providers to address coding-related queries and clarify documentation discrepancies

• Work closely with billing and revenue cycle teams to ensure accurate claims submission and facilitate timely reimbursement

• Conduct regular audits and quality checks on coded medical records to identify errors, inconsistencies, or opportunities for improvement

• Participate in coding compliance programs and initiatives to maintain accuracy and quality standards

To be considered for this position, applicants need to meet the following qualification criteria:

• Certified Professional Coder (CPC) or equivalent coding certification (e.g., CCS-P, CRC)

• In-depth knowledge of Evaluation and Management coding guidelines and principles

• Proficient in using coding software and Electronic Health Record (EHR) systems

• Familiarity with medical terminology, anatomy, and physiology

• Strong attention to detail and analytical skills

• Excellent communication and interpersonal skills

• Ability to work independently and as part of a team

• Compliance-oriented mindset and understanding of healthcare regulations

• Strong organizational and time management abilities

• Continuous learning mindset to stay updated on coding practices and changes

We're seeking medical coders with a minimum of 5 years of experience in E&M coding to join us in Pune. Apply now and grow your career at the fastest growing Healthcare RCM company!

• Able to deliver as per client SLAs

• Support operations through end-to-end planning and process document review

• Assist with new team member training and review overall staff performance

• Process KPI, dashboards and metrics preparations

• Excellent written and verbal communication

• Available to work from office

• Flexible to work in shifts as per business needs

• Minimum of 5 years working experience as medical coder

• Medical coding specialization in E&M is preferred

• Good knowledge of using PowerPoint, Excel and other MS Office tools

We are seeking an experienced and certified Medical Coding Trainer to facilitate training programs focused on Denial Management. The ideal candidate will possess strong analytical skills, expertise in medical coding using ICD-10-CM, CPT conventions, and HCPCS codes, and a deep understanding of the Revenue Cycle Management (RCM) cycle. The candidate must be AHIMA/AAPC certified and demonstrate the ability to communicate effectively and handle diverse groups of coders.

• Follow the training agenda and facilitate the training sessions for Coding – Denial Management

• Utilize proficient analytic skills to accurately code medical records using ICD-10-CM, CPT conventions, and HCPCS codes

• Browse payer guidelines to collate and provide the most accurate payer-specific information

• Interpret medical records across various specialties and provide appropriate denial actions based on analysis

• Handle and train diverse groups of new hires and existing coders.

• Mentor and develop coders' capabilities in denial management within the organization

• Provide Subject Matter Expert (SME) support for transitioning clients

• Conduct focus and compliance audits for all types of coders and auditors (ATA)

• Report and analyze trainees' performance to ensure client partners are ramping up to meet client and SD/SQ team standards

• Excellent communication and people skills

• Strong analytical skills and in-depth knowledge of the Revenue Cycle Management (RCM) cycle

• Minimum 5 years of work experience

  • 3 to 4 years in medical coding

  • 1 year in denial coding management

  • 1 year in trainer role

• Proven experience in a training role within Medical Coding or a related field

• Experience in training and mentoring coders

Key Responsibilities:  

• Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. 
• Understand the reason for rejection, denials, or no status from the payer. 
• Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email. 
• Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams. 
• Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail. 
• Ensure adherence to Standard Operating Procedures and compliance. 
• Highlight any global trend/pattern and issue escalation with the leadership team. 
• Meet the productivity and quality target on a daily/monthly basis. 
• Upskill by learning new/additional skills and enhancing competencies. Active participation in all process/client-specific training and refresher training. 

Requirements:  

• Undergraduate / Graduate in any stream with 2 to 4 years of experience in US Healthcare RCM for Account Receivable / Denial Management Resolution. 
• Fluent communication, both verbal and written. 
• Good analytical skills, attention to detail, and resolution-oriented. 
• Should have knowledge about the RCM end-to-end cycle and proficiency in AR fundamentals and denial management. 
• Basic knowledge of computers and MS Office. 

Preferred Qualities:  

• Eagerness to learn and grow within the finance team. 
• Ability to work both independently and collaboratively. 
• Time management skills and ability to meet deadlines in a fast-paced environment. 

Key Responsibilities:

• Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis.
• Understand the reason for rejection, denials, or no status from the payer.
• Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email.
• Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams.
• Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail.
• Ensure adherence to Standard Operating Procedures and compliance.
• Highlight any global trend/pattern and issue escalation with the leadership team.
• Meet the productivity and quality target on a daily/monthly basis.
• Upskill by learning new/additional skills and enhancing competencies. Active participation in all process/client-specific training and refresher training.

Requirements:

• Undergraduate / Graduate in any stream with 2 to 4 years of experience in US Healthcare RCM for Account Receivable / Denial Management Resolution.
• Fluent communication, both verbal and written.
• Good analytical skills, attention to detail, and resolution-oriented.
• Should have knowledge about the RCM end-to-end cycle and proficiency in AR fundamentals and denial management.
• Basic knowledge of computers and MS Office.

Preferred Qualities:

• Eagerness to learn and grow within the finance team.
• Ability to work both independently and collaboratively.
• Time management skills and ability to meet deadlines in a fast-paced environment.

Key Responsibilities:  

• Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis. 
• Understand the reason for rejection, denials, or no status from the payer. 
• Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email. 
• Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams. 
• Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail. 
• Ensure adherence to Standard Operating Procedures and compliance. 
• Highlight any global trend/pattern and issue escalation with the leadership team. 
• Meet the productivity and quality target on a daily/monthly basis. 
• Upskill by learning new/additional skills and enhancing competencies. Active participation in all process/client-specific training and refresher training. 

Requirements:  

• Undergraduate / Graduate in any stream with 2 to 4 years of experience in US Healthcare RCM for Account Receivable / Denial Management Resolution. 
• Fluent communication, both verbal and written. 
• Good analytical skills, attention to detail, and resolution-oriented. 
• Should have knowledge about the RCM end-to-end cycle and proficiency in AR fundamentals and denial management. 
• Basic knowledge of computers and MS Office. 

Preferred Qualities:  

• Eagerness to learn and grow within the finance team. 
• Ability to work both independently and collaboratively. 
• Time management skills and ability to meet deadlines in a fast-paced environment. 

• Validate all medical record documentation and charge information submitted by the physician to ensure compliance with coding/ billing regulations

• ·Notify or verify with physicians on all the changes and charges made

• Update changes after physician's acknowledgment

• Perform a variety of activities involving the Coding of medical records by ascribing accurate diagnosis and CPT codes as per ICD-10 and CPT-4 systems of Coding

• Review coding database annually to re-file insurance claims, verify insurance coverage, and secure other information as required

• Review insurance denials to analyze the causes and identify suitable solutions

• Discuss coding challenges, changes, or reimbursements with a physician

• Submit claims with appropriate documentation with OP notes and other information

• Update claims appropriately when patient data has been changed or corrected after charge posting

• Maintains a high degree of professional and ethical standards

• Focuses on continuous improvement by working on projects that enable customers to arrest revenue leakage while complying with the standards

• Focuses on updating coding skills, knowledge, and accuracy by participating in coding team meetings and educational conferences

To be considered for this position, applicants need to meet the following qualification criteria:

• Graduates in life sciences with 1 - 4 years experience in Medical Coding

• Prior experience in E&M coding, insurance, and posting required

• Experience in medical billing processes

• Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding

• CCS/CPC/CPC-H/CIC/COC certification from AAPC /AHIMA would be a plus

• Knowledge of HIPAA standards

• Prefer the Certified Professional Coding certificate

• Good knowledge of medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles

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