Supervisor, Denials

Ventra Health, Inc.; Coimbatore District; On-site; INR 6,214,000 - 8,604,000; Full time

Job summary

Ventra Health, Inc. is seeking a Supervisor, Denials to lead a team of Coding Denial Specialists responsible for health plan denials analysis and resolution. You will oversee daily denial operations, implement denial management policies, and monitor team performance.

The role emphasizes accuracy, speed, and collaboration, with emphasis on compliance and effective communication within a fast-paced healthcare environment.

Qualifications

• Experience in physician medical billing with emphasis on research and claim denials.
• Knowledge of health insurance, including coding and reimbursement guidelines.
• Familiarity with AHA Official Coding and Reporting Guidelines, CMS and ICD-10-CM/CPT coding.

Responsibilities

• Oversee the daily operations of the coding denial team.
• Ensuring the timely investigation and resolution of health plan denials.
• Implementing and maintaining policies and procedures for denial management.
• Monitoring and reporting on the productivity and performance of the team.
• Providing training and support to the team members to enhance their skills and knowledge.

Skills

Health Insurance

Coding knowledge

Denials management

Communication

Analytical skills

Excel Pivot

Team leadership

Policy procedures

Tools

Excel (Pivot Tables)

Database software

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.

Come Join Our Team!

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus!

Job Summary

• The Supervisor, Denials will manage and direct a team of Coding Denial Specialists, who are responsible for working assigned claim edits and rejection work queues, The Supervisor, Denials will ensure timely investigation and resolution of health plan denials. Additionally, the Supervisor, Denials will determine appropriate actions and provide resolution for health plan denials.

Essential Functions and Tasks

• Oversee the daily operations of the coding denial team.
• Ensuring the timely investigation and resolution of health plan denials.
• Implementing and maintaining policies and procedures for denial management.
• Monitoring and reporting on the productivity and performance of the team.
• Providing training and support to the team members to enhance their skills and knowledge.

Education and Experience Requirements

• Minimum of 3 months’ experience with Ventra.
• One to three years’ experience in physician medical billing with emphasis on research and claim denials.
• A current production and performance rating of no less than 95%.
• A current attendance rating of no less than 95%.

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 on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible for a discretionary incentive bonus in accordance with company 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.

Statement of AccessibilityVentra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.