Certified Medical Coder

Senior Medical Coding Specialist

About Triple

Triple is leading the way in remote work solutions, helping small and medium-sized businesses in North America build highly efficient remote teams for Administration, Customer Service, Accounting, Operations, and back-office roles. We focus on our Clients, People, and Planet, and we ensure our operations contribute positively across these key areas. Distinguished by its rigorous standards, Triple excels in:

• Selectively recruiting the top 1% of industry professionals
• Delivering in-depth training to ensure peak performance
• Offering superior account management for seamless operations

Embrace unparalleled professionalism and efficiency with Triple, where we redefine the essence of remote hiring.

Position Title

Senior Medical Coding Specialist Remote (India)

Work Schedule

Monday to Friday

5:30 PM – 2:30 AM IST

Full-Time

Position Overview

Triple is seeking an experienced Medical Coding & Revenue Integrity Specialist to support our US healthcare clients by ensuring the highest standards of coding accuracy, compliance, and revenue optimization.

This role will serve as the coding subject matter expert (SME) within the Revenue Cycle Management (RCM) team, responsible for reviewing medical documentation, validating diagnosis and procedure codes, identifying coding discrepancies, conducting audits, and educating billing teams on coding best practices.

The ideal candidate possesses deep expertise in physician-office coding, Evaluation & Management (E&M) services, ICD-10-CM, CPT, HCPCS, modifier usage, and Medicare guidelines. Experience supporting Internal Medicine and Family Medicine practices is highly preferred.

This position plays a critical role in reducing coding-related denials, improving clean claim rates, strengthening compliance, and maximizing reimbursement for our healthcare clients.

Key Responsibilities

Coding Review & Validation

• Review clinical documentation and validate ICD-10-CM, CPT, and HCPCS code selection.
• Ensure diagnosis and procedure codes accurately reflect services documented by providers.
• Verify coding accuracy prior to claim submission.
• Identify undercoding, overcoding, unbundling, and unsupported coding practices.
• Review documentation for medical necessity and payer compliance.
• Ensure proper linkage between diagnosis codes and procedures.
• Verify appropriate modifier assignment and usage.

E&M Coding Review

• Evaluate office visit coding based on current E&M guidelines.
• Review Medical Decision Making (MDM) components.
• Validate time-based coding when applicable.
• Identify opportunities to improve E&M coding accuracy.
• Provide recommendations regarding documentation deficiencies impacting code selection.

Revenue Integrity & Audit Functions

• Conduct routine coding audits across submitted and pending claims.
• Perform retrospective and prospective coding reviews.
• Identify coding trends resulting in denials or revenue leakage.
• Analyze coding accuracy metrics and recommend corrective actions.
• Prepare audit findings and present recommendations to leadership and client stakeholders.
• Support denial management teams in resolving coding-related denials.

Compliance & Quality Assurance

• Ensure adherence to CMS, Medicare, Medicaid, and commercial payer guidelines.
• Maintain compliance with federal regulations and coding standards.
• Monitor coding updates, annual CPT changes, ICD-10 updates, and payer-specific requirements.
• Assist with internal and external audit preparation.
• Support quality assurance initiatives across healthcare operations teams.

Training & Education

• Develop and deliver coding training programs for billers and RCM staff.
• Conduct refresher sessions on coding updates and compliance changes.
• Coach billing teams on documentation requirements and coding best practices.
• Create coding reference guides, SOPs, and educational materials.
• Participate in onboarding and ongoing development of RCM team members.

Client Collaboration

• Act as the coding SME for assigned healthcare clients.
• Participate in client meetings as needed to discuss coding performance and audit findings.
• Collaborate with providers, practice managers, billers, and account managers to improve coding workflows.
• Support implementation of client-specific coding policies and procedures.

Required Qualifications

• Minimum 3 years of experience in US Medical Coding.
• Strong experience with physician-office coding.
• Hands-on experience supporting Internal Medicine, Family Medicine, Primary Care, or Multi-Specialty practices.
• Expert knowledge of:
• ICD-10-CM
• CPT
• HCPCS
• Evaluation & Management (E&M) Coding
• Modifier Usage
• Medicare Guidelines
• Medical Necessity Requirements
• Experience conducting coding audits and chart reviews.
• Strong understanding of revenue cycle management processes.
• Experience working with Electronic Health Records (EHR/EMR) systems.
• Excellent analytical and problem-solving skills.
• Strong written and verbal English communication skills.
• Ability to work independently in a remote environment.

Preferred Qualifications

• CPC (Certified Professional Coder) certification through AAPC.
• CCS-P (Certified Coding Specialist – Physician-Based) certification through AHIMA.
• CPMA (Certified Professional Medical Auditor) certification.
• Experience supporting offshore healthcare operations teams.
• Experience conducting coding training and mentoring programs.
• Knowledge of HCC/Risk Adjustment Coding.
• Experience with Medicare Advantage and value-based care models.

Technical Requirements

Candidates must have:

• Reliable high-speed internet connection.
• Dedicated workspace free from distractions.
• Laptop/Desktop meeting company specifications.
• Ability to attend video meetings and training sessions.
• Backup internet connectivity preferred.

Key Performance Indicators (KPIs)

The Medical Coding & Revenue Integrity Specialist will be evaluated on:

Coding Quality

• Coding Accuracy %
• E&M Coding Accuracy %
• Modifier Accuracy %
• Audit Accuracy %

Revenue Integrity

• Reduction in Coding-Related Denials
• Reduction in Rework Rates
• Clean Claim Rate Improvement
• Revenue Leakage Identification & Prevention

Operational Excellence

• Audit Completion Targets
• Turnaround Time on Reviews
• Training Completion Rates
• Team Coding Competency Improvements

Client Satisfaction

• Client Feedback Scores
• Coding Compliance Performance
• Audit Findings Resolution Rate

What Success Looks Like

Within the first 90 days, the successful candidate will:

• Develop a comprehensive understanding of assigned client workflows.
• Establish coding audit processes and quality benchmarks.
• Identify key coding accuracy gaps across billing teams.
• Deliver targeted coding education to improve performance.
• Reduce coding-related denials and improve overall coding quality.
• Become the primary coding resource for both internal teams and client stakeholders.

Why Join Triple

• Work with leading healthcare organizations across North America.
• Be part of a high-performing remote-first culture.
• Opportunity to influence quality, compliance, and revenue outcomes at scale.
• Collaborative and supportive leadership team.
• Continuous learning and professional development opportunities.
• Career growth within a rapidly expanding healthcare operations organization.

If you are passionate about coding accuracy, compliance excellence, and improving healthcare revenue outcomes, we would love to hear from you.