About RapidClaims
RapidClaims is a leader in AI-driven revenue cycle management, transforming medical coding and revenue operations with cutting-edge technology.
The company has raised $11 million in total funding from top investors, including Accel and Together Fund.
Join us as we scale a cloud-native platform that runs transformer-based Large Language Models rigorously fine-tuned on millions of clinical notes and claims every month. You’ll engineer autonomous coding pipelines that parse ICD-10-CM, CPT® and HCPCS at lightning speed, deliver reimbursement insights with sub-second latency and >99 % accuracy, and tackle the deep-domain challenges that make clinical AI one of the hardest—and most rewarding—problems in tech.
Quality Control Analyst – Medical Coding
Auditor cum Subject Matter Expert (SME) | EM ED HM Coding
Position Snapshot
Designation-Quality Control Analyst – Medical Coding
Role Type-Medical Coding Auditor cum SME
Specialties-Evaluation & Management (EM), Emergency Department (ED), Hospital Medicine (HM)
Reports To-Head of Coding Integrity & Quality
Experience-5+ years in EM, ED & HM coding (audit / SME exposure preferred)
Location-Bangalore (Bengaluru), Karnataka
Work Mode-Work From Office – mandatory
Shift-Mid shift – 12:00 PM to 9:00 PM IST
Employment-Full-time
Role
We are seeking an experienced Medical Coding Auditor cum SME to ensure coding accuracy, compliance, and quality across AI-coded and human-coded charts in EM, ED, and HM specialties. The role combines hands-on chart auditing with subject-matter leadership — validating coding outputs, delivering structured feedback to coders, and partnering with SME and data science teams to drive continuous improvement of AI-assisted medical coding. The ideal candidate brings deep guideline knowledge (CMS / AMA / AHA), a sharp eye for error patterns, and the ability to translate coding expertise into actionable inputs for both operations and AI model development.
Coding Quality Audits
- Audit AI-coded and human-coded charts across EM, ED and HM queues Validate CPT, ICD-10-CM, HCPCS and modifier accuracy
- Verify correct EM level selection and documentation support
Error Identification & Analysis
- Identify missed codes, incorrect coding and compliance risks Document errors with clear CPT / ICD-10 / modifier rationale and guideline references
- Flag recurring error patterns for team-level education
Compliance Monitoring
- Ensure adherence to CMS, AMA and AHA guidelines and client-specific SOPs
- Apply updated guideline and coding changes to daily audit practice
Feedback & Education
- Deliver structured, case-level feedback to coders
- Conduct feedback discussions and support continuous learning Identify training needs and contribute to coder development
- AI Quality Support
- Audit AI-coded accounts and report discrepancies to the Head of CIQ Share audit findings with SME and ML teams
- Highlight repetitive AI errors and edge cases to improve model logic
- SME Contribution
- Serve as specialty reference point for EM, ED and HM coding queries
Provide guideline-based justifications for coding decisions
- Support SOP development and refinement for assigned specialties
- Reporting &
- Documentation
- Maintain accurate audit logs and quality metrics
- Submit timely audit findings for operational and ML review meetings
- Multi-Specialty Learning
- Pursue cross-specialty coding proficiency as directed
- Participate in training sessions and knowledge-sharing initiatives
- Required Qualifications & Skills
- ● Minimum 5+ years of medical coding experience with strong hands-on expertise in EM, ED and HM coding.
- ● Active coding certification – CPC, COC, CCS or equivalent (AAPC / AHIMA).
- ● In-depth knowledge of CPT, ICD-10-CM, HCPCS and modifier guidelines,
- and EM level documentation requirements.
- ● Sound understanding of CMS, AMA and AHA coding and compliance guidelines.
- ● Prior auditing and/or SME experience with proven error-analysis and feedback skills.
- ● Strong analytical, documentation and communication abilities.
- ● Comfortable working with AI / technology-driven coding workflows and collaborating with data science teams.
- Preferred /Good to Have
- ● Experience auditing AI-generated or automated coding outputs.
- ● Exposure to multiple specialties beyond EM / ED / HM.
- ● Experience contributing to SOPs, quality frameworks or coder training programs.
- Work Details
- LocationBangalore (Bengaluru) – on-site
- Work ModeWork From Office is mandatory (no remote / hybrid)
- Shift TimingMid shift, 12:00 PM – 9:00 PM IST
Benefits:
Work Location: In person
