Certified Coding Specialist

Job Summary

Working remotely, the full-time Coding Denials Resolution Specialist will review post-billed denials for coding accuracy, appeal denials based on coding expertise, and promote awareness of coding best practices within the revenue operations team.

Key responsibilities

• Review and appeal coding-related denials using ICD-10-CM, ICD-10-PCS, and CPT-4 codes
• Identify root causes of denials and track appeals through various levels of resolution
• Maintain knowledge of applicable laws and coding best practices to support departmental initiatives

Required qualifications

• High school diploma or Associate degree in a related field with a minimum of four years of relevant experience
• Comprehensive knowledge of professional diagnostic and procedural coding, with at least one year of coding experience
• Must hold credentials such as Certified Coding Specialist (CCS) or equivalent
• Experience with National Correct Coding Initiative edits and outpatient coding guidelines
• Detailed understanding of healthcare billing principles and medical terminology