CPC Certified Coding Specialist

Job Summary

Reviewing documentation and coding guidelines, the full-time remote Multispecialty Denials Coding Specialist will handle claim denials, submit appeals, and ensure timely payment for professional fee-based coding and evaluation services.

Key responsibilities

• Research payer denials related to referrals, pre-authorizations, and medical necessity to identify root causes of claim issues
• Submit detailed appeals to payers based on medical record reviews, adhering to Medicare, Medicaid, and third-party guidelines
• Ensure appropriate revenue capture to prevent audits and denials by demonstrating knowledge of insurance billing procedures

Required qualifications

• CPC and/or CCS, CCS-P, or RHIT certification from AAPC or AHIMA
• 5+ years of experience in physician-based denials
• 2 years of proficiency in profee multispecialty and E/M coding
• Strong knowledge of medical terminology, insurance, and appeals processes
• Proficiency with MS Office Suite and Athena software