Denials Multispecialty Coding Specialist - FacilityJob Summary The Denials Multispecialty Coding Specialist is responsible for reviewing, analyzing, and resolving coding-related claim denials for facility-based services across multiple specialties. The role ensures accurate code assignment, compliance with payer regulations, optimization of reimbursement, and reduction of denial rates through effective root-cause analysis and corrective action.
Key Responsibilities
- Review denied facility claims and identify coding-related denial causes.
- Analyze medical records, charge data, and payer denial information to determine appropriate corrective actions.
- Perform coding validation for inpatient, outpatient, emergency department, surgical, radiology, laboratory, and ancillary services.
- Apply ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and payer-specific coding guidelines accurately.
- Prepare and submit coding appeals with supporting clinical documentation.
- Collaborate with physicians, CDI teams, patient financial services, and revenue cycle departments to resolve denials.
- Conduct root-cause analysis and identify trends impacting reimbursement.
- Recommend process improvements to reduce coding errors and future denials.
- Maintain productivity and quality standards established by the organization.
- Monitor updates to coding regulations, payer policies, and compliance requirements.
- Participate in internal and external coding audits and implement corrective actions when required.
- Generate reports and provide denial resolution metrics to leadership.
Interested Candidates Reach out Out to Vedha Mithra HR (phone hidden) Pay: ₹25,000.00 - ₹75,000.00 per month