Multispecialty Denial Coder

Job Description

Role & responsibilities 1. Denial Management & Analysis Review and analyze denied claims across multiple specialties. Identify root causes for denials (e.g., coding errors, documentation deficiencies, payer policies). Categorize denials based on common patterns (e.g., medical necessity, bundling issues, coding specificity). 2. Coding & Compliance Perform accurate medical coding for denied claims using ICD-10-CM, CPT, and HCPCS codes. Ensure coding compliance with CMS, payer guidelines, and HIPAA regulations . Work with physicians and medical teams to clarify documentation and correct coding issues. Stay updated on payer-specific coding rules and regulatory changes. 3. Claims Correction & Resubmission Correct coding errors and resubmit claims within payer timelines. Prepare appeals with supporting documentation, coding guidelines, and medical records. Communicate effectively with insurance companies to resolve claim disputes. 4. Documentation Improvement & Provider Education Provide feedback to physicians and clinical staff on documentation best practices. Conduct training sessions to reduce recurring coding errors and denials. Recommend process improvements to prevent future claim rejections. 5. Reporting & Performance Tracking Maintain records of denied claims, resolutions, and financial impact. Generate reports on denial trends, coding accuracy, and revenue recovery. Collaborate with revenue cycle teams to improve overall claim acceptance rates. 6. Cross-functional Collaboration Work closely with billing teams, insurance follow-up specialists, and revenue cycle managers . Coordinate with compliance officers and auditors to ensure regulatory adherence. Communicate effectively with providers, payers, and leadership teams . Preferred candidate profile Candidate should have 1 to 3 years of experience in Multispecialty Denial Coder. Contact Details Interested candidates can share their resume to kaaviya.uppliraja@firstsource.com / Mobile No : 9150465315