- Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage
- Review and analyze denied claims and identify root causes
- Initiate outbound calls to provider offices for denial clarification and resolution
- Document call outcomes and update claim status in systems
- Ensure timely follow-up on pending claims to maximize reimbursement
- Adhere to client-specific guidelines and project requirements
- Maintain quality and productivity benchmarks as defined by the client
- Prepare reports and track performance using MS Excel / PPT
- Perform accurate CPT / ICD-10-CM coding with appropriate modifier usage
- Review and analyze denied claims and identify root causes
- Initiate outbound calls to provider offices for denial clarification and resolution
- Document call outcomes and update claim status in systems
- Ensure timely follow-up on pending claims to maximize reimbursement
- Adhere to client-specific guidelines and project requirements
- Maintain quality and productivity benchmarks as defined by the client
- Prepare reports and track performance using MS Excel / PPT
Qualifications & Skills (8–10 Points)
- Denial Experience (EM + Surgery) and 3+ Years after CPC/CCS is not mandatory
- Strong knowledge of CPT, ICD-10-CM, modifiers, E&M, and surgical coding
- Good understanding of Anatomy & Physiology
- Mandatory certification: CPC or CCS (No Apprentice credentials)
- Excellent communication skills with neutral accent (mandatory for calling role)
- Prior experience in voice process is an added advantage
- Ability to work in Eastern (US) shift
- High energy level with proactive and spontaneous approach
- Strong analytical and problem-solving skills
- Proficiency in MS Office (Excel & PowerPoint)
- Ability to understand client requirements and deliver accordingly
Telecommuting Requirement - Must be comfortable working in a telecommuting (remote/hybrid) setup as per business requirements
- Ensure stable internet connectivity and a distraction-free work environment for both coding and calling responsibilities q
Skills Required
- Denial experience (Emergency Medicine and Surgery)
- 3+ years post CPC/CCS experience
- Strong knowledge of CPT, ICD-10-CM, modifiers, E&M, and surgical coding
- Good understanding of Anatomy and Physiology
- Certification: CPC or CCS (No Apprentice credentials)
- Excellent communication skills with a neutral accent (mandatory for calling role)
- Prior experience in a voice process
- Ability to work Eastern (US) shift
- High energy level with proactive approach
- Strong analytical and problem-solving skills
- Proficiency in MS Office (Excel and PowerPoint)
- Ability to understand client requirements and deliver accordingly
- Comfortable working telecommuting (remote/hybrid); stable internet and distraction-free environment
What We Do
Choosing a digital partner is about more than capabilities — it’s about collaboration and character. Unrealistic overhauls and off-the-shelf products ignore what matters most — your unique needs, culture, goals, and your legacy data and technology environments. At EXL, our collaboration is built on ongoing listening and learning to adapt our methodologies. We’re your business evolution partner—tailoring solutions that make the most of data to make better business decisions and drive more intelligence into your increasingly digital operations. Whether your goals are scaling the use of AI and digital, redesign operating models, or driving better and faster decisions, we’re here to partner with you to help you gain—and maintain—competitive advantage with efficient, sustainable models at scale. Our expertise in transformation, data science, and change management helps make your business more efficient and effective, improve customer relationships and enhance revenue growth. Instead of focusing on multi-year, resource- and time-intensive platform designs or migrations, we look deeper at your entire value chain to integrate strategies with impact. We use our specialization in analytics, digital interventions, and operations management—alongside deep industry expertise — to deliver solutions that help you outperform the competition. At EXL, it’s all about outcomes—your outcomes—and delivering success on your terms. Share your goals with us and together, we’ll optimize how you leverage data to drive your business forward. For more information, visit www.exlservice.com.
