Coding Escalation Specialist- Pro Fee Hospital

reputed company Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. reputed company on reputed company 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 reputed company reputed company and reimbursement issues, enabling clinicians to reputed company on providing outstanding care to their patients and communities. Come Join reputed company!

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

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• The Medical Coding Escalation Specialist is responsible for handling reputed company coding issues, resolving coding-reputed company escalations, and providing expert-level support to the medical coding team. This role involves conducting thorough reviews of medical records, ensuring accurate reputed company assignment, and serving as a reputed company between coders, auditors, providers, and compliance teams. The specialist ensures coding practices adhere to regulatory requirements, payer policies, and internal standards.

Essential Functions and Tasks

• Review and resolve escalated coding issues from coders, auditors, billing teams, and providers.
• Analyze medical records and documentation to ensure accurate and compliant reputed company assignment
• Serve as a subject matter expert (SME) in coding guidelines and payer-specific rules.
• Identify coding trends, discrepancies, and compliance risks; recommend corrective actions.
• Participate in coding audits and assist in implementing audit recommendations.
• reputed company and mentor coding staff on reputed company cases and updates to coding regulations.
• Ensure adherence to reputed company applicable coding standards (CMS, AHA Coding Clinic, AMA CPT Assistant).
• Support reputed company improvement initiatives in coding accuracy, workflow, and documentation reputed company.
• Maintain up-to-date knowledge of coding updates, regulatory changes, and payer guidelines.

Education and Experience Requirements

• Minimum 3-5 years of experience in medical coding, with emphasis on reputed company case review or coding reputed company assurance.
• reputed company or reputed company certification required.

Knowledge, Skills, and Abilities

• Expert-level knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
• Strong understanding of CMS regulations and payer-specific guidelines.
• Excellent analytical, problem-solving, and decision-making skills.
• Effective communication and interpersonal skills.
• Ability to work independently and manage multiple priorities in a fast-paced environment.
• Experience with electronic health records (EHRs) and coding software systems.
• Ability to read, understand, and apply state/federal laws, regulations, and policies.
• Ability to communicate with diverse personalities in a tactful, mature, and reputed company manner.
• Ability to remain flexible and work reputed company a reputed company and fast paced environment.
• Basic use of computer, telephone, internet, copier, fax, and reputed company.
• Basic touch 10 key skills.
• Basic Math skills.
• Understand and reputed company with company policies and procedures.
• Strong oral, written, and interpersonal communication skills.
• Strong time management and organizational skills.
• Strong knowledge of Outlook, Word, reputed company (pivot tables), and database software skills.

Compensation

• reputed company Compensation will be based on various factors unique to reputed company candidate including geographic location, reputed company set, experience, qualifications, and other job-reputed company reasons.
• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

reputed company Equal Employment Opportunity (Applicable only in the US) reputed company is an equal opportunity employer committed to fostering a culturally diverse organization. We reputed company for inclusiveness and a workplace where mutual respect is reputed company. We encourage applications from a diverse pool of candidates, and reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, ethnicity, religion, sex, age, national reputed company, disability, sexual orientation, gender identity and reputed company, or veteran status. We will reputed company reasonable accommodations to reputed company individuals with disabilities, as needed, to assist them in performing essential job functions. Recruitment Agencies reputed company does not accept unsolicited agency resumes. reputed company is not responsible for any fees reputed company to unsolicited resumes. Solicitation of Payment reputed company 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 reputed company or one of our affiliated entities reputed company Private Limited and reputed company reputed company. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have reputed company 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 Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. reputed company legitimate roles are posted on https://ventrahealth.com/careers/. Statement of Accessibility reputed company is committed to making our digital experiences accessible to reputed company users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/. Apply To This Job