Coding Denial Specialist

Responsibilities

• Performs retrospective account reviews and resolves coding denials accordingly.
• Analyzes coding-related denials (e.g., bundling issues and inappropriate CPT/diagnoses) to identify trends and root causes.
• Proactively maintains current knowledge of applicable regulations, requirements, changes, and best practices by following industry sources (e.g., Centers for Medicare & Medicaid Services, American Association of Professional Coders, and professional journals).
• Reviews EPIC work queues daily for Denial management and makes necessary and appropriate coding changes based on medical documentation for both professional and technical charge revenue.
• Follows up with providers to resolve outstanding queries for additional documentation or diagnosis information.
• Coordinates and/or completes appeals as applicable with payors.
• Develops suggestions for coding and documentation process improvements, based on denial analysis and industry coding guidelines.
• Extracts data into clear reports to revenue recover and revenue cycle leadership, physician advisor, and providers.
• PARTNERS WITH REVENUE CYCLE TEAM LEADERS, PHYSICIANS, AND PROVIDERS TO DEVELOP AND IMPLEMENT PROCESS IMPROVEMENTS.
• Provides regular feedback and ad-hoc education to revenue recovery staff and providers to promote departmental knowledge of appropriate coding practices.

Requirements

• Experience in CPT and ICD coding is required.
• Experience working with all levels within an organization is required.
• Experience working in an Electronic Medical Record system preferred.
• Experience in healthcare is preferred.
• Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.

Qualifications

• Education: High School Diploma or equivalent is required; Bachelor's degree is preferred.
• Certification: AAPC or AHIMA Coding Certification is required.
• Years of relevant experience: 0 to 2 years is preferred.
• Years of experience supervising: None.

Skills

• Strong analytical skills.
• Excellent communication and interpersonal skills.
• Attention to detail.
• Ability to work independently and as part of a team.

Benefits

• Flexible remote work schedule.
• Competitive compensation package.
• Professional development opportunities.
• Health insurance benefits.

Pay

• $50,000 - $60,000 annually.

Schedule

• Full-time, 40 hours/week Monday-Friday 8am-4:30pm.