Quality Control Analyst -Auditor Medical Coding

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. Youll 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 hardestand most rewardingproblems in tech. Quality Control Analyst Medical Coding Auditor cum Subject Matter Expert (SME) | EM ED HM Surgery 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) Surgery 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 accuracyVerify correct EM level selection and documentation supportError Identification & Analysis Identify missed codes, incorrect coding and compliance risks Document errors with clear CPT / ICD-10 / modifier rationale and guideline referencesFlag recurring error patterns for team-level educationCompliance Monitoring Ensure adherence to CMS, AMA and AHA guidelines and client-specific SOPsApply updated guideline and coding changes to daily audit practiceFeedback & Education Deliver structured, case-level feedback to codersConduct feedback discussions and support continuous learning Identify training needs and contribute to coder developmentAI Quality SupportAudit AI-coded accounts and report discrepancies to the Head of CIQ Share audit findings with SME and ML teamsHighlight repetitive AI errors and edge cases to improve model logicSME ContributionServe 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 specialtiesReporting &DocumentationMaintain accurate audit logs and quality metricsSubmit timely audit findings for operational and ML review meetingsMulti-Specialty LearningPursue cross-specialty coding proficiency as directedParticipate in training sessions and knowledge-sharing initiativesRequired 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 DetailsLocationBangalore (Bengaluru) on-siteWork ModeWork From Office is mandatory (no remote / hybrid)Shift TimingMid shift, 12:00 PM 9:00 PM ISTBenefits: Provident FundWork Location: In person .