Ventra Health is a revenue cycle management company supporting facility-based physicians in anesthesia, emergency medicine, hospital medicine, pathology, and radiology.
This role focuses on coding denial management, including claim edits, rejections, down codes, bundling issues, modifiers, level of service, and other assigned work queues. The specialist investigates and resolves health plan denials, validates denial reasons, determines appropriate actions, and prepares appeals as needed.
The position is eligible for a performance-based incentive plan and a discretionary bonus.
Requirements & Qualifications
Qualifications
- High school diploma or equivalent
- 1 to 3 years of experience in physician medical billing with emphasis on research and claim denials
- Current AAPC or AHIMA certification preferred
- Knowledge of health insurance, coding, physician billing policies, and healthcare reimbursement guidelines
- Familiarity with AHA Official Coding and Reporting Guidelines, CMS directives, ICD-10-CM, and CPT coding
- Strong computer skills, including Outlook, Word, Excel, and database software
- Ability to work independently in a fast-paced environment
- Strong organizational, analytical, written, verbal, and interpersonal communication skills
Benefits & Perks
Benefits and Perks
- Performance-based incentive plan
- Discretionary incentive bonus
- Opportunity to work in a collaborative, team-oriented environment
- Equal opportunity employer
- Reasonable accommodations available for qualified individuals with disabilities
Location
N/A
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago
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