Company Healthcare Informatics Pvt Ltd HIPL Location Remote Anywhere in India Salary Competitive based on experience About the Company Healthcare Informatics Pvt Ltd HIPL established in 2006 is a leading healthcare services company specializing in Revenue Cycle Management RCM Medical Records Management and Healthcare IT solutions We serve medical billing companies clinics and hospitals by delivering high-quality services in Medical Transcription Medical Billing Coding and Information Technology with integrated database applications Job Summary We are hiring a Denial Specialist with strong Denial Management experience AND solid Medical Coding knowledge ICD CPT HCPCS Modifiers The ideal candidate is someone who can investigate denials deeply think logically and research in the correct direction rather than performing routine AR work This role demands real expertise not theoretical knowledge but true hands-on understanding of coding-driven denials Key Roles ResponsibilitiesDenial Management Expertise Manage technical clinical denials across multiple payers Perform detailed root-cause analysis on coding billing and documentation-related denials Work on appeals corrected claims and re-submissions with complete accuracy Identify denial patterns and recommend preventive actions to reduce recurring denials Handle CO PR denials coding edits bundling unbundling issues and medical necessity rejections Medical Coding ICD CPT Modifiers Validate coding accuracy using ICD-10 CPT HCPCS and modifier rules Apply correct modifiers 25 59 26 TC 51 RT LT etc as per payer and NCCI guidelines Review claim documentation and ensure compliance with LCD NCD and payer-specific rules Correct coding errors and update claims accurately before re-billing Research-Driven Work Your Key Requirement Only and ONLY research-oriented denial resolution no superficial rework Investigate coding logic payer edits NCCI rules and clinical documentation to resolve denials Provide clear reasoning behind every correction or appeal Stay updated with ICD CPT yearly changes payer policy updates and coding compliance standards What We Expect Solid Denial Management experience is mandatory Practical knowledge not theoretical of ICD-10 CPT HCPCS Modifiers Deep understanding of NCCI edits bundling rules LCD NCD and payer policies Candidates with 5 to 20 years of experience can apply but must be research-focused Ability to analyze denials identify exact issues and resolve them with coding accuracy Excellent documentation and communication skills Proficiency in RCM tools Athena eCW Epic Kareo etc is an advantage CPC-certified candidates are the perfect match for this position Why Join Us Opportunity to work with a growing healthcare team Exposure to multiple payer systems and credentialing processes Supportive and collaborative work culture Competitive compensation and career growth opportunities Job Type Full-time Pay From 480 000 00 per year Benefits Provident Fund Work from home Application Question s When you process a Medicare enrollment using PECOS what is the difference between handling an individual provider application and a group reassignment 855R Are you certified in Medical Coding CPC CCA CCS If yes mention your certification and year of completion Do you have hands-on experience in Denial Management including resolving coding-related denials ICD-10 CPT Modifiers Please explain briefly How do you perform research when handling a complex denial Describe your approach to identifying the correct root cause Work Location Remote

📌 Denial Specialist (with Medical Coding Experience) (India)
🏢 HEALTHCARE INFORMATICS
📍 India