Coding Denials Specialist

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Medsuite Inc

WebsiteLinkedInAll Job Openings

1 - 10 employees

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare Insurance • SaaS • HealthTech

Medsuite Inc. is a digital platform designed to streamline healthcare management and improve patient care. It provides tools for healthcare providers to manage patient records, appointments, and communications efficiently, all while prioritizing user-friendly access for patients and providers alike.

📋 Description

• Process accounts that meet coding denial management criteria including rejections and bundling issues. • Resolve work queues according to prescribed priority. • Validate denial reasons and ensures coding is accurate. • Generate appeals based on dispute reasons and contract terms. • Follow specific payer guidelines for appeals submission. • Escalate exhausted appeal efforts for resolution. • Maintain working knowledge of workflow, systems, and tools used in the department.

🎯 Requirements

• High school diploma or equivalent. • One to three years’ experience in physician medical billing with emphasis on research and claim denials. • Current AAPC or AHIMA certification required. • 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. • Good organizational and analytical skills. • Ability to work independently. • Strong oral, written, and interpersonal communication skills. • Strong time management and organizational skills.

🏖️ Benefits

• Ventra performance-based incentive plan • Referral Bonus