Certified Coding Denials Specialist

Job Summary

A company is looking for a Coding Denials Specialist to manage claim edits and resolve health plan denials.

Key Responsibilities

• Process accounts related to coding denial management, including rejections and bundling issues
• Validate denial reasons, ensure coding accuracy, and generate appeals based on dispute reasons
• Adhere to departmental production and quality standards while completing special projects as assigned

Required Qualifications

• High school diploma or equivalent
• One to three years of experience in physician medical billing, focusing on research and claim denials
• Current AAPC or AHIMA certification required
• Knowledge of health insurance coding and physician billing policies
• Familiarity with healthcare reimbursement guidelines and coding standards