<li>• Candidate must have E&M coding experience with minimum 2 years of work experience in Radiology coding denials with end to end knowledge including appealing / faxing and resolution. Should have an excellent command and proficiency in Radiology CPT /Modifier and Diagnosis Coding
• Should have in depth knowledge of all MACRA Measures, Modifiers, CCI Edits and LCD policies.
• Research denials related to CPT / Diagnosis/ Modifier/ Medical necessity, case management, non-covered services, and billing resulting in denials and delays in payment. Initiate appeals with insurers appropriately. Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines.
• Identify denial patterns and escalate to management as appropriate with sufficient information for additional follow-up, and/or root cause resolution Make recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency and reduce denials.</li>

E&M Surgery / ED Coders