Role & 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

Preferred candidate profile

- 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 setting.
- 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.

Perks and benefits

📌 Denial Coding Specialist - EM/ ED Speciality (Chennai)
🏢 Ventra Health
📍 Chennai