Clinical Coder Reimbursement Analyst

1 Position

India - Hyderabad

Company Overview: 

ZignaAI is focused on delivering innovative solutions that transform healthcare payment operational processes. We empower payers, providers and patients with AI powered software solutions that drive transparency in healthcare payment services.  Built-in intelligence enabled machine learning algorithms deliver pre-billing payment accuracy solutions and avoid provider abrasion. We differ from traditional payment services solutions by resolving issues at root by ensuring accurate payments, automating processes, with nudges delivered to billing coders. Our innovative and scalable solutions cover Medicaid, Medicare and Commercial policies. 

Opportunity Overview: 

Full-time position, in-office, Hyderabad. This position will require the candidate to engage critical thinking skills, be intellectually curious, and demonstrate great attention to detail.  Requires excellent communications skills both written and oral. Must possess the ability to work with a diverse group of talent both in-person and globally.  

 

Orientation period of 90 days (about 3 months). 

 
Responsibilities: 

  • Work respectfully with a diverse team of professionals to meet the needs of ZignaAI healthcare payment solutions and projects. 
  • Arrange, prepare for, attend and run team meetings as needed. 
  • Be a self-motivated team member who will complete work tasks as assigned and timely. 
  • Apply coding guidelines and payor policies to generate payment edits. 
  • Demonstrate knowledge of and compliance with changes and updates to coding guidelines, reimbursement trends, client processes and requirements. 
  • Comply with all ZignaAI policies and procedures including HIPAA and other state and federal regulations. 
  • Work a shift that overlaps time zones for IST and EST/EDT. 
  • The medical coding team member provides expert consultation on coding & clinical policy guidelines. 
  • This role is responsible for interpreting and assessing US Medical Healthcare company payment policies and building edits. This role requires the medical coder to understand USA professional and facility claim billing. This role requires the medical coder to understand USA home healthcare billing.  
  • This role works with a diverse team of professionals at all levels in a global work environment. 
  • Clearly understands and articulates medical policies. 
  • Conducts research and analysis for medical policy edits and CMS, State, and Federal Guidelines.  
  • Communicates effectively with various client team members (internal and external). 
  • Responds to client (internal and external) inquiries in a timely manner in compliance with policy and procedures 
  • Assists the internal team by researching new trends and applications for new rules. 
  • Ability to transfer knowledge to junior staff and colleagues.  
  • Completes all responsibilities as outlined on annual Performance Plan. 
  • Completes all special projects and other duties as assigned. 

  
Minimum Qualifications: 

We are a startup and expect each team member to wear multiple hats, take initiative, and spot and solve problems. 

  • Able to work in-office, Hyderabad, India. 
  • Bachelor’s degree. CPC or CCS certification required. 
  • Superior knowledge of ICD-10-CM/PCS coding, HCPCS codes, CPT codes, modifiers, understanding of US healthcare payment methodologies for Commercial, Marketplace, Medicare, and Medicaid, Home Healthcare, 4-6 years. 
  • Proficient in Excel and Word and professional use of email and Teams. 
  • Effective presentation, verbal and written communication, and interpersonal skills. 
  • Must have flexibility and willingness to participate in the work processes of an international organization, including conference calls scheduled to accommodate global time zones. 

  
Knowledge, Skills, Behaviors: 

  • Takes responsibility for work assignments, tasks and timelines.   
  • Possesses excellent time management and work prioritization skills. 
  • Takes ownership of problem solving. 
  • Demonstrates excellent written and verbal communication skills, strong analytical skills, and attention to detail. 
  • Works well within a team regarding communication, sharing ideas, and respect for co-workers, company, and clients. 
  • Ability to analyze complex data and synthesize. 
  • Ability to work well both independently and with a team. 
  • Welcomes learning, problem-solving and working as a team to deliver outstanding products with outstanding support.  

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