Professional, Financial Analysis
advantum
Professional, Coding (Denial)
advantum· CODINGOP
About this role
Position Overview
The Lab & Path Denial Coder is responsible for reviewing, analyzing, and resolving claim denials related to laboratory and pathology services. This role ensures accurate coding, supports denial prevention, and works closely with billing, QA, and provider teams to improve reimbursement outcomes.
Key Responsibilities
1. Denial Review & Resolution
- Analyze payer denial codes for Lab & Pathology claims.
- Identify root causes such as coding errors, missing documentation, medical necessity issues, or payer-specific rules.
- Correct CPT, HCPCS, ICD‑10, and modifier usage as required.
- Prepare and submit corrected claims or appeals with supporting documentation.
2. Coding Accuracy
- Assign accurate CPT/HCPCS codes for:
- Clinical laboratory tests
- Anatomic pathology
- Molecular pathology
- Cytopathology
- Microbiology
- Ensure compliance with NCCI edits, LCD/NCD guidelines, and payer policies.
3. Documentation Review
- Validate that provider documentation supports billed services.
- Request additional documentation when needed.
- Identify documentation gaps and communicate trends to leadership.
4. Payer Policy Knowledge
- Stay updated on Medicare, Medicaid, and commercial payer rules for Lab & Path services.
- Understand frequency limitations, bundling rules, and medical necessity requirements.
5. Collaboration & Reporting
- Work with billing, AR, QA, and coding teams to reduce recurring denials.
- Provide feedback on denial trends and coding improvement opportunities.
- Maintain productivity and quality benchmarks.
Required Skills & Qualifications
- 2–4 years of experience in Lab/Pathology coding or denial management.
- Strong knowledge of CPT (80000 series), ICD‑10‑CM, and HCPCS Level II.
- Familiarity with:
- Molecular pathology codes (e.g., 81162, 812xx series)
- Surgical pathology (88300–88309)
- Cytology (88104–88175)
- Experience with payer denial codes and appeal processes.
- Certification preferred: CPC, COC, CIC, or equivalent.
- Strong analytical and communication skills.
Performance Expectations
- Meet daily/weekly denial resolution targets.
- Maintain coding accuracy of 95%+.
- Reduce repeat denials through root‑cause identification.
- Ensure timely submission of corrected claims and appeals.
Frequently Asked Questions
Is the salary disclosed for the Professional, Coding (Denial) position at advantum?
The salary for this Professional, Coding (Denial) role at advantum is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Professional, Coding (Denial) position at advantum located?
This Professional, Coding (Denial) role at advantum is based in Hyderabad, TG, India. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
Is the Professional, Coding (Denial) role at advantum full-time or part-time?
This is listed as a FULL TIME position. It is posted as a Professional, Coding (Denial) role in the CODINGOP department at advantum.
Which team or department does the Professional, Coding (Denial) at advantum belong to?
This Professional, Coding (Denial) position is part of the CODINGOP department at advantum. See the full job description for more information about the team structure and responsibilities.
How do I apply for the Professional, Coding (Denial) position at advantum?
Click the "Apply Now" button on this page. You will be redirected to advantum's official application portal hosted on keka where you can submit your application directly.
When was the Professional, Coding (Denial) job at advantum posted?
This Professional, Coding (Denial) position at advantum was posted on Jun 9, 2026. Apply as soon as possible — early applications are often reviewed first.
Professional, Coding (Denial)
advantum
You'll be redirected to advantum's official application page on keka.