Job Description

Company:

Healthcare Informatics Pvt. Ltd. (HIPL)

Location:

Remote (Anywhere in India)

Salary:

Competitive & based on experience

About the Company:

Healthcare Informatics Pvt. Ltd. (HIPL)

, established in 2006, is a leading healthcare services company specializing in

Revenue Cycle Management (RCM)

,

Medical Records Management

, and

Healthcare IT solutions

. We serve medical billing companies, clinics, and hospitals by delivering high-quality services in

Medical Transcription, Medical Billing & Coding

, and

Information Technology

with integrated database applications.

Job Summary:

We are hiring a

Denial Specialist

with

strong Denial Management experience AND solid Medical Coding knowledge (ICD, CPT, HCPCS, Modifiers)

.
The ideal candidate is someone who can

investigate denials deeply, think logically, and research in the correct direction

rather than performing routine AR work.

This role demands real expertise --

not theoretical knowledge -- but true hands-on understanding

of coding-driven denials.

Key Roles & ResponsibilitiesDenial Management Expertise:

Manage

technical & clinical denials

across multiple payers. Perform

detailed root-cause analysis

on coding, billing, and documentation-related denials. Work on appeals, corrected claims, and re-submissions with complete accuracy. Identify denial patterns and recommend

preventive actions

to reduce recurring denials. Handle

CO/PR denials, coding edits, bundling/unbundling issues

, and medical necessity rejections.

Medical Coding (ICD, CPT, Modifiers):

Validate coding accuracy using

ICD-10, CPT, HCPCS

, and modifier rules. Apply correct modifiers (25/59/26/TC/51/RT/LT etc.) as per payer and NCCI guidelines. Review claim documentation and ensure compliance with LCD/NCD and payer-specific rules. Correct coding errors and update claims accurately before re-billing.

Research-Driven Work (Your Key Requirement):

Only and ONLY research-oriented

denial resolution -- no superficial rework. Investigate coding logic, payer edits, NCCI rules, and clinical documentation to resolve denials. Provide clear reasoning behind every correction or appeal. Stay updated with

ICD/CPT yearly changes

, payer policy updates, and coding compliance standards.

What We Expect:

Strong Denial Management experience is mandatory.

Practical knowledge (not theoretical) of ICD-10, CPT, HCPCS & Modifiers. Deep understanding of NCCI edits, bundling rules, LCD/NCD, and payer policies. Candidates with

5 to 20+ years

of experience can apply -- but must be research-focused. Ability to analyze denials, identify exact issues, and resolve them with coding accuracy. Excellent documentation and communication skills. Proficiency in RCM tools (Athena, eCW, Epic, Kareo, etc.) is an advantage.

CPC-certified candidates are the perfect match for this position.

Why Join Us:

Opportunity to work with a growing healthcare team. Exposure to multiple payer systems and credentialing processes. Supportive and collaborative work culture. Competitive compensation and career growth opportunities.
Job Type: Full-time

Pay: From ?480,000.00 per year

Benefits:

Provident Fund Work from home
Application Question(s):

When you process a Medicare enrollment using PECOS, what is the difference between handling an individual provider application and a group reassignment (855R)? Are you certified in Medical Coding (CPC/CCA/CCS)? If yes, mention your certification and year of completion. Do you have hands-on experience in Denial Management, including resolving coding-related denials (ICD-10, CPT, Modifiers)? Please explain briefly. How do you perform research when handling a complex denial? Describe your approach to identifying the correct root cause.
Work Location: Remote