i
Ventra Health
Compare
All Filters
1 Ventra Health Specialist Job
Coding Denials Specialist
1-3 years
Kolkata, Mumbai, New Delhi + 4 more
1 vacancy
Coding Denials Specialist
Ventra Health
posted 24d ago
Job Role Insights
Fixed timing
Key skills for the job
Job Description
- 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.
- 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.
- High school diploma or equivalent.
- One to three years experience in physician medical billing with emphasis on research and claim denials.
- Knowledge of health insurance, including coding.
- Thorough knowledge of physician billing policies and procedures.
- Thorough knowledge of healthcare reimbursement guidelines.
- Knowledge of AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding.
- Computer literate, working knowledge of Excel helpful.
- Able to work in a fast-paced environment.
- Good organizational and analytical skills.
- Ability to work independently.
- Ability to communicate effectively and efficiently.
Proficient computer skills, with the ability to learn applicable internal systems.
Ability to work collaboratively with others toward the accomplishment of shared goals. - Basic use of computer, telephone, internet, copier, fax, and scanner.
- Basic touch 10 key skills.
- Basic Math skills.
- Understand and comply with company policies and procedures.
- Strong oral, written, and interpersonal communication skills.
- Strong time management and organizational skills.
- Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.
Employment Type: Full Time, Permanent
Read full job descriptionPrepare for Specialist roles with real interview advice
What Specialist at Ventra Health are saying
Specialist salary at Ventra Health
What Ventra Health employees are saying about work life
Ventra Health Benefits
View more benefits
Compare Ventra Health with
Eisai Pharmaceuticals
Star Hospitals
Echs Polyclinic
American Oncology Institute
Kolors Healthcare
Batra Hospital
Unipath Specialty Laboratory
Coloplast
Velammal Medical College Hospital & Research Institute
Calibrated Healthcare Systems
KARL STORZ
Bhagwan Mahaveer Jain Hospital
Iqraa International Hospital & Research Centre
Principle Security & Allied Services
Ortho Clinical Diagnostics
Vasan Health Care
Sohana Hospital
Davita Nephrolife Care
Santokba Durlabhji Memorial Hospital
Bhagirathi Neotia Woman & Child Care Centre
Similar Jobs for you
