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