Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Overview The Coding Denial Specialist responsibilities include working assigned claim edits and rejection work ques, Responsible for the timely investigation and resolution of health plan denials to determine appropriate action and provide resolution. Responsibilities Processes accounts that meet coding denial management criteria which includes rejections, down codes, bundling issues, modifiers, level of service and other assigned ques. Resolve work queues according to the prescribed priority and/or per the direction of management in accordance with policies, procedures, and other job aides. Validate denial reasons and ensures coding is accurate. Generate an appeal based on the dispute reason and contract terms specific to the payor. This includes online reconsiderations. Follow specific payer guidelines for appeals submission. Escalate exhausted appeal efforts for resolution. Adhere to departmental production and quality standards. Complete special projects as assigned by management. Maintain working knowledge of workflow, systems, and tools used in the department. Qualifications High school diploma or equivalent. One to three years’ experience in physician medical billing with emphasis on research and claim denials.

Role & responsibilities Performs ongoing analysis of medical record documentation and codes assigned per CMS, CPT, and Ventra Health documentation guidelines.Assign appropriate ICD-10-CM and CPT codes and modifiers according to documentation.Perform MIPS review as needed.Perform Provider QA as needed.Document coding errors.Assist coding management.Assist with client/provider audits as needed.Assist with reviewing work product of new coders in training, as needed.Provides feedback to coders on coding discrepancies/deficiencies, as needed.Provides feedback to coding manager on documentation deficiencies in a timely manner.Respond to questions from designated coders.Maintain confidentiality for all personal, financial, and medical information found in medical records per HIPAA guidelines and Ventra Health policy. Understand the use and function of modifiers in CPT.In-depth knowledge of CPT/ICD-10 coding system.Ability to read and interpret documentation and assign appropriate codes for diagnosis and procedures. Ability to read, understand, and apply state/federal laws, regulations, and policies.Ability to remain flexible and work within collaborative and fast paced environment. Ability to communicate with diverse personalities in a tactful, mature, and professional manner. Knowledge of the requirements of medical record documentation.Knowledge of medical terminology and anatomy.Strong oral, written, and interpersonal communication skills. Strong time management and organizational skills.Basic use of computer, telephone, internet, copier, fax, and scanner. Basic knowledge of Outlook, Word, and Excel. Become proficient in the use of billing software within 4 weeks and maintain proficiency. Understand and comply with company policies and procedures.Preferred candidate profile High School diploma or equivalent.RHIT and/or CPC required.At least one (1) year of medical billing preferred.Number of Openings - 50Location - Guindy Contact Person - Santhiya 9384426766

,Job Summary: We are seeking a Decision Support Analyst to provide data-driven insights and support decision-making within our Revenue Cycle Management (RCM) organization. The role focuses on leveraging data analysis and trending to optimize operational efficiency and drive strategic initiatives. This position will also play a key role in logging, managing, and remediating client escalations in partnership with Service Delivery and Client Success teams to enhance client satisfaction. The ideal candidate is skilled in using Excel, Power BI, and other analytical tools, with strong written and verbal communication skills to effectively collaborate with internal stakeholders. Data Analysis and Reporting:Analyze complex datasets to identify trends, root causes, and opportunities for improvement in RCM operations.Develop and maintain dashboards and reports using Power BI and Excel.Provide actionable insights and recommendations based on data analysis to inform decision-making.Decision Support:Collaborate with internal teams to support strategic planning and operational initiatives.Use data to evaluate the impact of proposed changes and identify the best course of action.Present data findings and insights in a clear, concise manner to non-technical stakeholders.Performance Monitoring:Track and analyze key performance indicators (KPIs) to measure operational effectiveness.Identify variances from expected performance and recommend corrective actions.Provide regular updates to leadership on performance trends and data insights.Client Escalation Management:Log and track client escalations in coordination with Service Delivery and Client Success teams.Prioritize escalations and communicate resolution timelines to stakeholders.Work closely with owning teams to remediate issues promptly and ensure client satisfaction.Collaboration and Communication:Partner with internal customers to understand their data needs and develop tailored solutions.Act as a liaison between technical teams and business units to ensure alignment.Prepare and deliver presentations to various audiences, including leadership teams.Education and Experience Requirements:Bachelor's degree in Business Administration, Data Analytics, Healthcare Management, or a related field. Equivalent experience may be considered.2-4 years of experience in data analysis, business intelligence, or a related role, preferably within the healthcare or RCM industry.Hands-on experience with Power BI and advanced Excel functionalities (e.g., pivot tables, formulas, and macros).Knowledge, Skills, and Abilities:Strong analytical and problem-solving skills with a focus on identifying actionable insights.Proficiency in data visualization tools, including Power BI and Excel.Exceptional written and verbal communication skills for working with diverse teams.Ability to manage multiple projects and prioritize tasks in a fast-paced environment.Strong mathematical and data analysis capabilities.Ability to read, understand, and apply state/federal laws, regulations, and policies.Ability to communicate with diverse personalities in a tactful, mature, and professional manner.Ability to remain flexible and work within a collaborative and fast paced environment.Basic use of computer, telephone, internet, copier, fax, and scanner.Basic touch 10 key skills.Basic Math skills. Understand and comply with company policies and procedures.Strong oral, written, and interpersonal communication skills.Strong time management and organizational skills.Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Overview We are seeking a knowledgeable and experienced individual to join our team as a Medical Coding Trainer. The ideal candidate will have a deep understanding of medical coding principles, particularly within the context of the US healthcare system. This role involves developing and delivering training programs to equip medical coding professionals with the necessary skills and knowledge to excel in their roles. ResponsibilitiesCurriculum Development: Design and develop comprehensive training curriculum covering various aspects of US healthcare medical coding, including CPT, ICD-10, HCPCS, and medical terminology.Training Delivery: Conduct engaging and informative training sessions, both in-person and virtually, to individuals and groups of medical coding professionals. Ensure that training materials are up-to-date and aligned with industry standards.Quality Assurance: Evaluate the effectiveness of training programs through assessments, feedback, and performance metrics. Continuously update and refine training materials to meet the evolving needs of the healthcare industry.Subject Matter Expertise: Serve as a subject matter expert on multi-specialty (Anesthesia / EM/ Radiology, etc.) medical coding practices, regulations, and compliance requirements in the US healthcare system. Stay informed about changes and updates in coding guidelines and communicate these to trainees effectively.Mentorship and Support: Provide ongoing support and mentorship to trainees, assisting them in applying their knowledge effectively in real-world scenarios. Address any challenges or questions related to medical coding with professionalism and expertise.Collaboration: Work closely with other departments, such as human resources, compliance, and operations, to ensure alignment of training programs with organizational goals and objectives. Qualifications Bachelor's degree in any related field. Master's degree preferred. Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required. Minimum of 5 years of experience in medical coding & 2 years of experience in training, with a strong understanding of CPT, ICD-10, and HCPCS coding systems.