Medical Coder

NKU Technologies is seeking a skilled Medical Coder with experience in US healthcare coding, particularly in Chronic Care Management (CCM) and Advanced Primary Care Management (APCM) services. The ideal candidate will be responsible for reviewing medical records, assigning accurate ICD-10, CPT, and HCPCS codes, and ensuring compliance with coding standards and Medicare regulations. This role involves conducting coding audits, supporting billing accuracy, and collaborating with clinical teams to resolve documentation and coding issues. Staying current with coding guidelines and payer policies is essential to support proper reimbursement and maintain high-quality coding practices.

Key Responsibilities

- Review clinical documentation and assign precise ICD-10, CPT, and HCPCS codes, including those specific to CCM and APCM services.
- Verify that documentation meets CCM billing requirements such as patient consent, care plans, and time spent on services.
- Assign appropriate APCM G-codes based on patient complexity and ensure documentation aligns with program standards.
- Detect coding conflicts, for example, when CCM and APCM services are coded for the same patient within the same period.
- Perform regular coding audits, provide constructive feedback, and promote improvements in coding accuracy and compliance.
- Develop and implement coding strategies that facilitate accurate billing and optimize reimbursement.
- Collaborate with healthcare providers and clinical staff to clarify documentation and resolve coding inquiries.
- Assist in resolving coding-related denials and work to prevent recurring errors.
- Support training initiatives for coding staff, sharing updates on CCM/APCM coding and best practices.
- Maintain up-to-date knowledge of CMS guidelines, annual coding changes, and payer policies.
- Recommend and help implement process improvements to enhance coding workflows.

Required Qualifications

- Bachelor’s degree or higher.
- 3 to 4 years of experience in US Medical Coding or Medical Billing.
- Strong proficiency in ICD-10, CPT, and HCPCS coding systems.
- Experience or solid understanding of CCM and/or APCM coding and documentation requirements.
- Good knowledge of the full revenue cycle management (RCM) process.
- Current knowledge of Medicare regulations and third-party payer compliance standards.
- Strong analytical abilities and effective communication skills.
- Ability to build collaborative relationships with clinicians, managers, and clients.
- Aptitude for identifying process improvement opportunities and implementing solutions.

Preferred Qualifications and Benefits

- Professional certification such as CPC, CCS, or equivalent is preferred.
- Experience in auditing or coding quality assurance is an advantage.
- Previous work experience with US healthcare providers or medical billing companies is desirable.
- Competitive salary starting from Rs1,400,000.00 per month.
- Hybrid remote work arrangement based in Lahore.

This role offers an excellent opportunity to contribute to a growing healthcare technology company by ensuring coding accuracy and compliance while supporting efficient billing processes.