Job Summary
Brief Description
Overview: A Denial Management Medical Coder is responsible for analysing, correcting, and preventing denied insurance claims through accurate multi-speciality coding and thorough documentation review.
Key Responsibilities
-
Review and analyze denied claims to identify root causes, patterns, and trends.
-
Accurately assign CPT, ICD-10-CM, and HCPCS codes in compliance with payer guidelines.
-
Verify documentation to support claim resubmissions, prepare and submit corrected claims.
-
Collaborate with billing teams and payers to resolve denials and track corrective actions.
-
Prepare denial trend and error analysis reports; conduct training for coders based on trend errors.
Preferred Skills
Technical Expertise & Qualifications
-
Technical Domains: Urology, Radiation Oncology, Neurosurgery/Spine, Office & Hospital E/M, Labs, and Surgery.
-
Experience: Minimum 4+ years in Multi-Speciality Denial Coding. Surgery denial knowledge is mandatory.
-
Education/Certification: Graduate in Life Sciences, Nursing, Pharmacy, or related field. Mandatory CPC, CCS, or equivalent certification.
-
Core Skills: Knowledge of Medicare/Medicaid denial scenarios, EOB, copays, adjustments, RCA, and global benchmarks (e.g., 5% error tolerance).
-
Immediate joiners are highly preferred.
Please mention job code MEDDMMC in the subject line