State Licensed Coding Specialist

Job Summary

A company is looking for a Coding Denial Resolution Specialist I to identify, investigate, and resolve coding-related denials from payers.

Key Responsibilities

• Execute tasks focused on revenue generation through account resolution
• Review documentation to support or contest payer coding decisions and prepare appeals
• Investigate root causes of denials, resubmit corrected claims, and provide training on coding practices

Required Qualifications

• High school diploma or equivalent (GED) required; associate or bachelor's degree 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 reimbursement regulations
• Experience using EHR/EMR systems for billing and account resolution