Certified Coding Denials Specialist

Job Summary

To support the revenue cycle management team, the full-time remote Certified Coding Denials Specialist will manage claim edits and rejection work queues, investigate health plan denials, and ensure accurate coding and timely resolution of issues.

Key responsibilities

• Process accounts related to coding denial management, including rejections and bundling issues
• Generate appeals based on dispute reasons and payer guidelines, ensuring compliance with submission protocols
• Maintain adherence 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 with a focus on claim denials
• Current AAPC or AHIMA certification is required
• Thorough knowledge of healthcare reimbursement guidelines and physician billing policies
• Proficient in computer skills, including knowledge of Excel and other relevant software