Senior Executive -Multispecialty Denials / Code Edit

Job description

**Job Summary:** code edit cum caller responsible for medical coding and telephonic interaction with provider offices to resolve claim denials. The role requires strong coding expertise along with effective communication skills to ensure timely claim resolution. The candidate must balance accuracy, productivity, and client communication while adhering to quality standards. **Job Description :** - Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage - Review and analyze denied claims and identify root causes - Initiate outbound calls to provider offices for denial clarification and resolution - Document call outcomes and update claim status in systems - Ensure timely follow-up on pending claims to maximize reimbursement - Adhere to client-specific guidelines and project requirements - Maintain quality and productivity benchmarks as defined by the client - Prepare reports and track performance using MS Excel / PPT **Qualifications & Skills :** - Strong knowledge of CPT, ICD-10-CM, modifiers, E&M, and surgical coding - Good understanding of Anatomy & Physiology - Mandatory certification: CPC or CCS (No Apprentice credentials) - Excellent communication skills with neutral accent (mandatory for calling role) - Prior experience in voice process is an added advantage - Ability to work in Eastern (US) shift - High energy level with proactive and spontaneous approach - Strong analytical and problem-solving skills - Proficiency in MS Office (Excel & PowerPoint) - Ability to understand client requirements and deliver accordingly **Telecommuting Requirement** - Must be comfortable working in a telecommuting (remote/hybrid) setup as per business requirements - Ensure stable internet connectivity and a distraction-free work environment for both coding and calling responsibilities