Medical Coder US Healthcare, Oncology

• Review and resolve medical coding-related denials for US healthcare claims.
• Analyze rejected and denied claims to identify coding errors and discrepancies.
• Perform charge corrections and claim rebilling wherever required.
• Review medical records and clinical documentation to validate coding accuracy.
• Apply appropriate CPT, ICD-10-CM, and HCPCS codes based on documentation and applicable guidelines.
• Identify and apply appropriate modifiers as per coding guidelines and payer requirements.
• Investigate coding-related denial reasons and determine appropriate corrective actions.
• Work on aged AR accounts and support recovery of outstanding receivables.
• Ensure timely resolution of coding denials within defined turnaround times.
• Maintain accuracy, productivity, and quality standards.
• Escalate complex coding issues to the Manager or designated team lead.
• Follow HIPAA regulations and client-specific compliance requirements.

Required Skills & Qualifications

• 26 years of experience in US Medical Coding.
• Strong understanding of CPT, ICD-10-CM, and HCPCS coding.
• Knowledge of coding denials and claim rejection management.
• Good understanding of modifiers and their appropriate usage.
• Experience in charge corrections and rebilling.
• Ability to interpret medical documentation and identify coding discrepancies.
• Strong analytical and problem-solving skills.
• Good communication and documentation skills.

Preferred Qualifications

• Prior experience in Oncology coding.
• Exposure to Medical Oncology, Radiation Oncology, Infusion, or Chemotherapy coding.
• Experience in US healthcare AR denial management.
• Knowledge of payer-specific coding guidelines and reimbursement processes.
• Experience handling aged AR accounts.