Denials Medical Coder

Roles and Responsibilities :

• Review and analyze denied claims to identify reasons for denial and assign appropriate ICD-10, CPT, and HCPCS codes.
• Resolve coding-related denials by making necessary corrections and ensuring compliance with payer-specific guidelines.
• Work closely with billing and accounts receivable teams to resubmit corrected claims promptly.
• Investigate trends in claim rejections and implement strategies to minimize denial rates.
• Liaise with healthcare providers and teams to clarify documentation discrepancies affecting claim approvals.
• Ensure claims meet industry standards and payer-specific policies for successful reimbursement.
• Maintain accurate records of denial cases and resolutions for reporting purposes.
• Stay up to date on coding guidelines, healthcare regulations, and payer policy updates.
• Meet productivity and quality benchmarks established by the organization.
• Maintain confidentiality and adhere to HIPAA regulations in handling patient information.

Skills Required

Cpc, Cpt, Radiology, Icd