Coding Suspend Specialist

🔥 5 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 10%

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Ventra Health

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2021

🏥 Healthcare

☁️ SaaS

🤝 B2B

Healthcare • SaaS • B2B

Ventra Health is a healthcare revenue cycle management (RCM) company that provides end-to-end medical billing, coding, claims management, denial prevention, payer contracting, and collections services for hospitals, health systems, and physician practices across the U. S. Its offerings combine domain expertise and white‑glove client service with proprietary data and AI-powered platforms—vCision (AI & automation) and vSight (data & analytics)—to improve reimbursement, reduce denials, accelerate cash collections, and deliver measurable RCM performance improvements. Ventra emphasizes enterprise service delivery, provider education, compliance and coding audits, patient responsibility management, and payer strategy, serving thousands of providers and facilities nationwide.

📋 Description

• Review and analyze coding-related suspends generated by coding software or systems • Identify errors, discrepancies, and missing information • Review medical records, encounter forms, and relevant documentation to validate code assignments and ensure compliance • Research and interpret CPT, ICD-10, HCPCS, payer-specific requirements, coding guidelines, policies, and regulations • Assign and sequence diagnosis and procedure codes accurately • Collaborate with coding and billing staff, clinicians, and other stakeholders to gather information and resolve coding issues • Correct code assignments, modifiers, and other coding elements to address suspends and ensure accurate claim submission • Document coding activities, findings, and resolutions in coding systems • Communicate coding trends, issues, and best practices; provide education, training, and support • Monitor coding guideline, regulatory, and payer policy changes and implement necessary updates • Assist with coding audits, reviews, and compliance initiatives • Participate in coding-related meetings, committees, and projects

🎯 Requirements

• Bachelor's degree in any Life Science field • Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or related coding certification required • Minimum of 2–3 years of experience in medical coding, with a focus on coding suspends and denials • In-depth knowledge of CPT, ICD-10, HCPCS, and other coding systems and guidelines • Familiarity with coding software and systems, including encoders, grouper software, and Electronic Health Record (EHR) systems • Strong analytical and problem-solving skills • Excellent attention to detail and accuracy • Effective communication and interpersonal skills • Proficiency in medical terminology, anatomy, physiology, and disease processes • Ability to work independently and prioritize tasks in a fast-paced healthcare environment • Willingness to stay updated on coding-related trends, regulations, and best practices through continuing education and professional development

🏖️ Benefits

• Performance-based incentive plan • Discretionary incentive bonus • Referral bonus • Professional development and continuing education opportunities • Reasonable accommodations for qualified individuals with disabilities