Welcome Back

Google icon Sign in with Google
OR
I agree to abide by Pharmadaily Terms of Service and its Privacy Policy

Create Account

Google icon Sign up with Google
OR
By signing up, you agree to our Terms of Service and Privacy Policy
Instagram
youtube
Facebook

Coding Suspends Specialist

Ventra Health
Ventra health
2-3 years
preferred by company
Hyderabad
1 May 13, 2026
Job Description
Job Type: Full Time Education: M.Pharm/B.Pharm or M.Sc. Skills: Environment, Experiments Design, Health And Safety (Ehs), Laboratory Equipment, Manufacturing Process, Materials Science, Process Simulation, Sop (Standard Operating Procedure), Technical Writing, Wat, GCP guidelines, gmp knowledge, HSE Knowledge , Logistics and Transportation Management, Master Data, Operational Excellence, Sap Erp, supply chain management, Supply Planning, Warehouse Management, ICD-10 CM Codes, CPT-Codes, HCPCS Codes

Job Title: Coding Suspends Specialist

Location: Hyderabad, India (Hybrid)
Job Type: Full-Time
Shift: Day Shift
Experience Required: 2–3+ Years
Industry: Healthcare / Medical Coding / Revenue Cycle Management / Medical Billing / Healthcare Operations
Department: Medical Coding / Coding Suspends / Revenue Cycle Operations

About the Role

We are hiring an experienced Coding Suspends Specialist to support healthcare coding exception management, claim issue resolution, coding validation, and reimbursement optimization within a healthcare revenue cycle environment. This role is ideal for professionals with expertise in medical coding, coding suspends, denial resolution, CPT, ICD-10, HCPCS, claim correction, and coding compliance.

The ideal candidate will review coding-related suspends, analyze claim errors, validate medical documentation, correct coding discrepancies, and ensure timely claim submission for accurate reimbursement.

This opportunity is ideal for experienced certified medical coders seeking specialized roles in coding issue resolution and healthcare revenue cycle operations.

Key Responsibilities

Coding Suspends Review & Resolution

  • Review and analyze coding-related suspends generated by coding software or billing systems.
  • Identify coding errors, discrepancies, incomplete documentation, and claim submission blockers.
  • Resolve coding suspends efficiently to support accurate and timely reimbursement.

Medical Coding Validation

  • Review patient medical records, encounter forms, physician documentation, and supporting clinical records.
  • Validate diagnosis and procedure coding assignments for accuracy and compliance.
  • Ensure claims are coded correctly before submission.

Code Assignment & Correction

  • Research and apply correct coding using:
    • CPT
    • ICD-10
    • HCPCS
    • Modifiers
    • Payer-specific coding requirements
  • Correct diagnosis codes, procedure codes, sequencing issues, and modifier errors affecting claims.

Claim Issue Resolution

  • Investigate coding-related denials, suspended claims, and billing exceptions.
  • Resolve documentation gaps and coding mismatches impacting reimbursement workflows.
  • Support claim cleanup and coding correction processes.

Documentation Review & Clarification

  • Collaborate with:
    • Coding teams
    • Billing teams
    • Clinicians
    • Revenue cycle stakeholders
  • Gather missing documentation or clarification required for accurate coding resolution.

Coding Compliance & Regulatory Adherence

  • Interpret and apply healthcare coding standards and regulations including:
    • CPT guidelines
    • ICD-10 standards
    • HCPCS rules
    • Payer-specific policies
    • Coding compliance requirements
  • Ensure claim coding aligns with reimbursement and regulatory expectations.

Coding Activity Documentation

  • Record coding findings, issue analysis, corrections, and resolutions within coding platforms and workflow systems.
  • Maintain accurate coding audit trails and claim history documentation.

Training & Knowledge Sharing

  • Communicate recurring coding trends, denial patterns, and documentation improvement opportunities.
  • Support coding teams with education and best-practice guidance to improve coding accuracy.

Audit & Quality Improvement Support

  • Participate in coding audits, quality reviews, compliance initiatives, and coding improvement programs.
  • Identify coding error patterns and recommend process enhancements.

Continuous Learning & Industry Updates

  • Stay current with coding regulation changes, payer updates, reimbursement policies, and coding best practices.
  • Apply updated coding standards to daily operations.

Cross-Functional Collaboration

  • Participate in coding meetings, operational discussions, and healthcare revenue cycle improvement initiatives.
  • Provide subject matter expertise in coding suspend management workflows.