Medical Denial QA / QC

Access Healthcare

3 - 8 years

4 - 9 Lacs

Chennai Tamil Nadu India

Posted:21 hours ago| Platform: Foundit logo

Apply

Skills Required

Quality Control Audit Medical Denial Denial Management Medical Billing

Work Mode

On-site

Job Type

Full Time

Job Description

Medical Denial Quality Assurance (QA) / Quality Control (QC)

Key Responsibilities

Perform
QA/QC reviews
of denied medical claims to identify root causes and coding/billing errors.
Analyze
denial trends
and patterns to provide actionable insights for process improvements.
Verify the accuracy of information used in appealing denied claims, including coding, documentation, and payer-specific guidelines.
Collaborate with
AR (Accounts Receivable) teams
and coders to implement corrective actions and prevent future denials.
Develop and deliver
training sessions
to enhance team knowledge on denial prevention and effective appeal strategies.
Maintain comprehensive records of audit findings, corrective actions, and their impact on denial rates.
Ensure adherence to industry regulations and compliance standards related to medical billing and denials.

Qualifications

Certification:
Relevant
coding or billing certification
is preferred.
Experience:
Demonstrated experience in
medical billing, AR follow-up
, and
denial management
.

Skills

Strong analytical and problem-solving skills
for complex denial scenarios.
In-depth knowledge of medical billing cycles, claim submission processes, and payer guidelines
.
Excellent
communication skills
, both written and verbal, for reporting and collaboration.
Proficiency in medical billing software and relevant office applications.
Ability to work meticulously and identify subtle discrepancies in documentation.

More Jobs at Access Healthcare

Hiring of Medical coding @ Access Healthcare

Chennai

3 - 8 yrs

INR 8 - 13 Lacs

Hiring HCC Coder / QA

Chennai

1 - 6 yrs

INR 2 - 7 Lacs

AR caller - Hospital Billing

Chennai

1 - 3 yrs

INR 2 - 5 Lacs

Medical Coding Experience 1 - 6 yrs

Pune, Chennai, Coimbatore

1 - 6 yrs

INR 2 - 7 Lacs

Accounts Payable Associate

Chennai

1 - 4 yrs

INR 3 - 4 Lacs

Mock Interview

Practice Video Interview with JobPe AI

Start Job-Specific Interview

Start Your Job Search Today

Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.