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