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

📌 Claim Edits Specialist (Chennai)
🏢 Ventra Health
📍 Chennai