Certified Coding Specialist

Job Summary

To support operations remotely, the Coding Denial Resolution Specialist will investigate and resolve coding-related denials from payers, ensuring compliance with regulations while maximizing client reimbursements through timely corrections and appeals.

Key responsibilities:

• Execute revenue generation tasks through account resolution for clients
• Review documentation to contest payer coding decisions and prepare appeals as needed
• Investigate root causes of denials and provide targeted training on coding practices

Required qualifications:

• High school diploma or equivalent (GED) required; Associate or bachelor's degree in healthcare management preferred
• Current/active CCS or CPC certification required
• Minimum of 3 years' experience resolving payer denials and conducting coding audits
• Advanced knowledge of ICD-10, CPT/HCPCS, and payer reimbursement regulations
• Experience using EHR/EMR systems for billing and account resolution