Coding Denials Specialist
Ventra · Chennai · onsite · Posted 57d ago
Undisclosed1–5 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
Overview
- The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution.
Responsibilities
- Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques.
- Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides.
- Validate denial reasons and ensures coding is accurate.
- Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations.
- Follow specific payer guidelines for appeals submission.
- Escalate exhausted appeal efforts for resolution.
- Adhere to departmental production and quality standards.
- Complete special projects as assigned by management.
- Maintain working knowledge of workflow, systems, and tools used in the department.
Qualifications
- High school diploma or equivalent.
- One to three years’ experience in physician medical billing with emphasis on research and claim denials.
- Current AAPC or AHIMA certification required.
Sourced from naukri
Skills
Charge Postingcharge entryRCMicdmedical codingcpcclaims adjudicationPayment PostingRevenue Cycle ManagementDenial ManagementDenialsUS HealthcareARcodingHealthcareAccounts ReceivableMedical BillingAR CallingSpring BootJavaClaims Processing
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
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