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Supervisor, Coding Denials

4 months ago

Perungudi Chennai Tamil Nadu, India Ventra Health, Inc. Full time

About Us:

- Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, 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.

Job Summary:

- The Supervisor, Coding Denials manages the daily operations of the coding denials and appeals team. This position must maintain an awareness of payer guidelines and updates. Develops strategies to optimize staff performance through process redesign, policy/procedure implementation, communications, and outcome feedback.

Essential Functions and Tasks:

- Develop and maintain coding denial management processes and procedures.
- Manage the clinical appeals staff, appeals inventory, and workflow management.
- Ensure appeals are completed and filed timely and accurately
- Ensure departmental production and quality standards are met.
- Continuously evaluate and implement process improvements to enhance efficiency and effectiveness of coding denial management.
- Provide ongoing training and development.
- Monitor and analyze coding denial trends to implement strategies for prevention and improvement.
- Collaborate with other departments to identify and address coding issues that lead to denials.
- Complete special projects as assigned by management.
- Maintain working knowledge of workflow, systems, and tools used in the department.

Education and Experience Requirements:

- High school diploma or equivalent.
- At least five (5) years of physician and/or hospital medical coding related experience preferred.
- At least two (2) years of supervisory/management/leadership experience preferred.

Knowledge, Skills, and Abilities:

- Knowledge of health insurance, including coding.
- Thorough knowledge of physician billing policies and procedures.
- Thorough knowledge of healthcare reimbursement guidelines.
- Knowledge of AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding.
- Computer literate, working knowledge of Excel helpful.
- Able to work in a fast-paced environment.
- Good organizational and analytical skills.
- Ability to work independently.
- Ability to communicate effectively and efficiently.
- Proficient computer skills, with the ability to learn applicable internal systems.
- Ability to work collaboratively with others toward the accomplishment of shared goals.
- 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 Health:
**Equal Employment Opportunity (Applicable only in the US)**

**Recruitment Agencies**

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

**Solicitation of Payment**

Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.