Surgical Coding Denial Specialist

About the role

The Surgical Coding Denial Specialist will resolve insurance claim denials for assigned surgical specialty departments to enhance revenues for CU Medicine providers. This role requires 3-5 years of experience in medical practice billing with exposure to denials, appeals, insurance collections, and related follow-up. A bachelor’s degree in a related field is preferred, and CPC certification is required. Strong ICD-10 and CPT coding skills are necessary, along with surgery experience preferred.

Responsibilities

• Appeal denials through coding review, contract review, and medical record review
• Generate effective written appeals to carriers using well-researched logic
• Utilize a multitude of resources to ensure correct appeal processes are followed
• Investigate account complexities and provide solutions
• Communicate identified denial patterns to management
• Prioritize and process large volumes of denials while maintaining high quality work
• Serve as an escalation point for unresolved denial issues
• Inform team members of payer policy changes
• Aid in training new employees as needed
• Collaborate on special projects as needed

Requirements

• 3-5 years experience in medical practice billing with denials, appeals, insurance collections, and follow-up
• Bachelor’s degree in a related field preferred
• CPC certification required
• Surgery experience preferred
• Intermediate PC software experience required

Qualifications

• Strong ICD-10 and CPT coding skills
• Ability to analyze and resolve complex denials
• Excellent verbal and written communication skills
• Understanding and ability to apply contract language

Skills

• Effective problem-solving and analytical skills
• Strong organizational and prioritization skills
• Excellent interpersonal and communication skills
• Ability to work independently and as part of a team

Benefits

CU Medicine offers a comprehensive benefits package including generous leave, health plans, and retirement contributions. Find more details about our benefits here.

Pay

Commensurate with experience.

Schedule

Remote work is available.