Denials Specialist

🔥 0 minutes ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

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

• Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques • Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides • Validate denial reasons and ensures coding is accurate • Generate an appeal based on the dispute reason and contract terms specific to the payor • Follow specific payer guidelines for appeals submission • Escalate exhausted appeal efforts for resolution • Adhere to departmental production and quality standards • Complete special projects as assigned by management • 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 • Ability to communicate effectively and efficiently • Proficient computer skills, with the ability to learn applicable internal systems • Basic Math skills

🏖️ Benefits

• Ventra performance-based incentive plan • Referral Bonus