Claim Edits Specialist
Ventra · Chennai · onsite · Posted 66d ago
Undisclosed2–4 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
Overview
- Ensures claims accuracy by reviewing, validating, and correcting claim edits prior to submission to payers, thereby minimizing denials and rejections.
Responsibilities
- Analyze pre-submission claim edits and apply corrective actions per payer and client guidelines
- Track claim edit trends and recommend rule updates or automation improvements
- Work with coding and charge entry teams to resolve edit discrepancies.
- Track claim edit trends and recommend rule updates or automation improvements.
- Maintain quality and productivity standards as per departmental SLAs.
- Collaborate with the QA and configuration teams to enhance edit logic efficiency.
- Assist in preparing reports and root cause analyses for repeated edit failures.
Qualifications
- High School Diploma or GED.
- At least two to four (2-4) years of medical billing and claims resolution experience preferred
- AAHAM and/or HFMA certification preferred
- Experience with offshore engagement and collaboration desired
Sourced from naukri
Skills
ResolutionBillingonshoreProblem SolvingOffshoreclaims adjudicationoilengagementpresentation skillsTrainingUS HealthcareClaimsLeadership SkillsHealthcareTeamworkMedical BillingCommunication SkillsHealth insuranceClaims ProcessingRecruitment
About Ventra Health
Ventra
Healthcare
3k+
employees
2021
5 years old
Chennai, India
India
₹4.9L PA avg
Avg at Ventra Health
About
Revenue cycle management and advisory services for facility-based physicians
Industries
Healthcare
Employee ratings
0 reviews
3.0/ 5
Employees rate it well for
Compensation & Benefits31Work-Life Balance31
Find them on