Healthcare Denials Coder - Remote

Overview

We are seeking a detail-oriented and analytical Healthcare Denials Coder to join our dynamic team. The successful candidate will be responsible for investigating, analyzing, and resolving denied medical claims. This role is crucial to our revenue cycle, as it involves identifying the root causes of denials, correcting coding and billing errors, and submitting appeals to payers to ensure proper reimbursement for services rendered. The ideal candidate will possess a strong understanding of medical coding guidelines, payer policies, and the appeals process.

In Short

• Review and analyze denied, rejected, and underpaid claims to determine denial root causes.
• Utilize knowledge of coding guidelines to correct and resubmit claims.
• Prepare and submit appeals to insurance carriers in a timely manner.
• Communicate with insurance companies regarding appeal statuses and denial reasons.
• Identify and report denial trends to management.
• Document all actions taken on claims in the patient accounting system.
• Stay updated with changes in coding regulations and healthcare laws.
• Collaborate with coding and billing teams for feedback and education.
• Manager may assign tasks outside of key responsibilities.

Requirements

• 1-3 years of experience in medical coding, billing, and/or denials management.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
• Knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems.
• Understanding of medical terminology, anatomy, and physiology.
• Familiarity with payer guidelines and the appeals process.
• Proficiency with electronic health records (EHR) and medical billing software.
• Excellent written and verbal communication skills.
• Strong analytical and problem-solving abilities.
• Attention to detail and high degree of accuracy.
• Ability to work independently and in a team.

Benefits

• Opportunity to work in a dynamic team environment.
• Development of skills in medical coding and denials management.
• Potential for career advancement in the healthcare field.