Supervisor, Coding Denials

Ventra Health, Inc.; Chennai District; On-site; INR 5,774,783 - 8,662,175; Full time

Job summary

Ventra Health is seeking a Coding Denial Supervisor to lead a team of Coding Denial Specialists, directing efforts on claim edits and denial queues. You will ensure timely investigations and resolutions of health plan denials while guiding actions and resolutions for denial issues.

Ideal candidates have five years of physician medical billing experience with denials focus, a life science background, and AHIMA/AAPC credentials. Strong leadership, communication, and analytical skills are essential.

Qualifications

• Five years’ experience in physician medical billing with emphasis on research and claim denials.
• Graduate with life science background, paramedic/alternate medicine background is preferred
• Valid AAPC/AHIMA coding certification; specialty certification is preferred

Responsibilities

• Ensure timely investigation and resolution of health plan denials
• Assist in implementing and maintaining policies and procedures for denial management
• Provide training and support to team members to enhance skills and knowledge
• Escalate coding and processing issues based on denial trends

Skills

Healthcare billing

Denials management

Analytical skills

Communication

Time management

Education

Life science degree

Paramedic/health background (preferred)

AAPC/AHIMA certification (preferred)

Tools

Excel

Billing systems

Job description

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary

Coding Denial Supervisor to provide direction to a team of Coding Denial Specialists, who are responsible for working on assigned claim edits and rejection work queues. The Coding Denial Supervisor will ensure timely investigation and resolution of health plan denials. Additionally, the Coding Denial Supervisor will assist in determining appropriate actions and providing resolutions for health plan denials.

Essential Functions and Tasks

• Ensuring the timely investigation and resolution of health plan denials
• Assist in Implementing and maintaining policies and procedures for denial management
• Providing training and support to the team members to enhance their skills and knowledge
• Escalate coding and processing issues, based on denial trending.

Education and Experience Requirements

• Five years’ experience in physician medical billing with emphasis on research and claim denials.
• Graduate with life science background, paramedic/alternate medicine background is preferred
• Valid AAPC/AHIMA coding certification; specialty certification is preferred

Knowledge, Skills, and Abilities

• 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 environment.
• 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.
• 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.

Compensation

• Base Compensation will be based onvarious factorsunique to eachcandidateincluding geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible fora discretionaryincentivebonusin accordance withcompany policies.

Ventra Health

Equal Employment Opportunity (Applicable only in the US)Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.Recruitment AgenciesVentra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.Solicitation of PaymentVentra Health does not solicit payment from our applicants and candidates for consideration or placement.