CPC Certified Denials Specialist

Job Summary

Reviewing documentation and coding guidelines, the full-time remote Multispecialty Denials Specialist will research claim denials, submit appeals, and manage claims correspondence to ensure timely payment for services rendered.

Key responsibilities

• Research payer denials related to various factors, including medical necessity and billing issues
• Submit detailed, customized appeals to payers based on medical record reviews and compliance with guidelines
• Demonstrate knowledge of insurance billing procedures to identify root causes of claim issues and propose resolutions

Required qualifications

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