Job Description

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.
- Come Join Our Team
- As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe outstanding work deserves great rewards.
- Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus

Job Summary
- 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.

Essential Functions And Tasks




- 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.

Education And Experience Requirements
- High school diploma or equivale

📌 Coding Denials Specialist (Hyderabad)
🏢 Ventra Health
📍 Hyderabad