Supervisor, Coding Denials

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.

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• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

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Coding Denial Supervisor to provide direction to a team of Coding Denial Specialists, who are responsible for working on assigned claim edits and rejection work queues.

The Coding Denial Supervisor will ensure timely investigation and resolution of health plan denials.

Additionally, the Coding Denial Supervisor will assist in determining appropriate actions and providing resolutions for health plan denials.

• Ensuring the timely investigation and resolution of health plan denials
• Assist in Implementing and maintaining policies and procedures for denial management
• Providing training and support to the team members to enhance their skills and knowledge
• Escalate coding and processing issues, based on denial trending.
• Five years’ experience in physician medical billing with emphasis on research and claim denials.
• Graduate with life science background, paramedic/alternate medicine background is preferred
• Valid AAPC/AHIMA coding certification; specialty certification is preferred
• 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.