Denial Code / Eligibility Verification Specialty

Dear Candidates,

Urgent Requirement

Position - Denial Coder

Exp - 2 to 4 Years

Qualification - Any Graduate

Jobs Description

Responsibilities:

• Review denied ophthalmology claims and determine the root cause (coding, documentation, eligibility, etc.).
• Correct and resubmit claims with accurate CPT/ICD-10 coding.
• Work with supervisors and coding staff to resolve documentation deficiencies.
• Prepare and submit appeals with supporting medical documentation.
• Track denial trends and recommend process improvements.
• Stay updated on payer policies and ophthalmology coding guidelines.

Qualifications:

• 3 and above years of medical coding experience (ophthalmology preferred).
• Certified Professional Coder (CPC) or equivalent strongly preferred.
• In-depth knowledge of ophthalmology-specific coding, modifiers, and LCD/NCD guidelines.
• Strong analytical and problem-solving skills.
• Flexible working in Shifts

Total Exp

Relevant Exp

Notice Period

Qualifications

Current Company

Current Locations

Current CTC

Expected CTC

Shift Timing - 5pm to 2am

Interested candidates kindly share your above details with updated resume at vim.s.shaw@pwc.com

Urgent Requirement

Position - Eligibility Verification Specialist

Exp - 2 to 4 Years

Qualification - Any Graduate

Jobs Description

Responsibilities:

• Verify patient insurance eligibility and benefits prior to scheduled visits or procedures.
• Confirm coverage for exams, diagnostic tests (OCT, visual fields, etc.), and surgical procedures.
• Document copays, deductibles, coinsurance, and authorization requirements.
• Communicate insurance details to patients and front office staff.
• Work with insurance carriers to resolve eligibility issues.
• Maintain up-to-date records for compliance and billing accuracy.

Qualifications:

• 2 and above years of experience in medical eligibility verification.
• Familiarity with payer requirements.
• Strong communication and customer service skills.
• Ability to manage multiple verification requests in a timely manner.
• Flexible working in Shifts

Total Exp

Relevant Exp

Notice Period

Qualifications

Current Company

Current Locations

Current CTC

Expected CTC

Shift Timing - 5pm to 2am

Interested candidates kindly share your above details with updated resume at vim.s.shaw@pwc.com

Regards

Vim Kumar Shaw

Talent Acquisition