Supervisor, Coding Denials

About Us

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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Job Summary

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.

Essential Functions and Tasks

• 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.

Education and Experience Requirements

• 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, 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.
• 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.

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons.

• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Ventra Health

Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. 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 Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention Candidates 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.To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at [email protected] to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.

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