Job Summary

Experienced in analyzing and resolving coding-related denials across multiple specialties by reviewing medical records, payer guidelines, and claim edits to ensure accurate reimbursement and compliance.

Roles & Responsibilities

- Review and analyze denied claims for coding and billing discrepancies.

- Identify root causes of denials related to CPT, ICD-10-CM, HCPCS, modifiers, and documentation.

- Correct coding errors and resubmit claims for reimbursement.

- Prepare and submit payer appeals with supporting medical documentation.

- Monitor denial trends and recommend corrective actions.

- Ensure compliance with CMS, payer-specific, and coding guidelines.

- Collaborate with providers, billers, and revenue cycle teams.

- Perform denial audits to improve coding quality and reduce denial rates.

- Maintain productivity and accuracy standards.

Key Skills

- Denials Management
- Multi-Specialty Coding

- CPT Coding
- ICD-10-CM Coding

- HCPCS Coding

- Modifier Review
- Appeals & Reconsiderations

- Revenue Cycle Management (RCM)

- Claim Analysis

- Medical Necessity Review

- Documentation Review

- Coding Compliance

📌 Medical Coder & QA - Denials (Multi-Specialty) Navi Mumbai
🏢 ECLAT Health Solutions
📍 Mumbai