Certified Coding Denials Specialist

Job Summary

Working remotely on a full-time basis, the Certified Coding Denials Specialist will manage claim edits and rejection work queues, ensuring timely investigation and resolution of health plan denials while adhering to departmental standards.

Key responsibilities

• Process accounts related to coding denial management, including rejections and bundling issues
• Generate appeals based on denial reasons and payer guidelines, ensuring accurate coding
• Adhere to 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 required
• Thorough knowledge of healthcare reimbursement guidelines and coding policies
• Proficient computer skills, including working knowledge of Excel