Multispecialty Denials (E/M)

Q Way Technologies

1 - 6 years

3 - 8 Lacs

Chennai

Posted:3 weeks ago| Platform:

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Skills Required

Analytical skills Rework Claims HCPCS Compliance Coding Billing CMS medical records Management

Work Mode

Work from Office

Job Type

Full Time

Job Description

Experience:

Minimum 1 Year

Shift:

Day Shift

Job Summary: We are looking for an experienced Medical Coder with expertise in Evaluation and Management (E/M) coding to handle multispecialty denial resolutions. The ideal candidate will be responsible for reviewing denied E/M claims, identifying root causes, and ensuring accurate recoding or appeal submission in accordance with payer policies.

Key Responsibilities:
Review and rework denied claims related to E/M services across various specialties.

Analyze medical records and documentation to assign accurate CPT, ICD-10, and HCPCS codes.

Identify reasons for denials such as level-of-service issues, lack of documentation, or bundling edits.

Draft and submit appeals with clinical justification based on payer-specific guidelines.

Coordinate with AR and billing teams to ensure timely claim resolution.

Maintain high accuracy and compliance with CMS, payer, and internal guidelines.

Meet productivity and quality targets as defined by management.

Required Skills:

Proficient in E/M coding and documentation guidelines (2021+ updates).

Strong understanding of multispecialty billing and denial patterns.

Experience working with coding software and EMR/EHR platforms.

Familiarity with payer rules, including Medicare and commercial insurers.

Excellent attention to detail, communication, and analytical skills.

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