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Clinical Denials Coding Review Specialist Jobs (NOW HIRING)

PathGroup

Coding Specialist

Nashville, TN · On-site

Coding Specialists increase and expedite service revenue, reduce aged AR, and trend denials for ... coding denials prevention. JOB RESPONSIBILITIES ESSENTIAL FUNCTIONS: * Performs front-end review of ...

MU Health

LPN - Clinical Denials Specialist

Columbia, MO · On-site

$22.14 - $34.59/hr

... denials. • Review payer communications, identifying risk for loss reimbursement related to ... PREFERRED QUALIFICATIONS • Experience with medical and insurance terminology, CPT, ICD-10 coding ...

ScionHealth

Clinical Denials Nurse-Appeals (Remote)

Participate in telephone clinical reviews and multidisciplinary discussions regarding patient care ... Educate hospital staff, case managers, and coders regarding managed care and coding-related denial ...

Posted today

WVU Medicine

Clinical Denials Coord

Morgantown, WV · On-site

Other duties may be assigned. 1. Completes clinical appeal writing for insurance denials. 2. Evaluates each patient medical record reviewing specific documents relating to patient treatment and ...

West Virginia University Health System

Other duties may be assigned. 1. Completes clinical appeal writing for insurance denials. 2. Evaluates each patient medical record reviewing specific documents relating to patient treatment and ...

Franciscan Alliance

Clinical Denials Assistant

Indiana, PA · On-site

$16.50 - $21/hr

IHP provides advanced cardiac imaging and participates in research and clinical trials to bring ... Review and manage cardiac testing denials, including submitting appeals, coordinating peer-to-peer ...

WVU Medicine

Clinical Denials Coord

Morgantown, WV · On-site

Other duties may be assigned. 1. Completes clinical appeal writing for insurance denials. 2. Evaluates each patient medical record reviewing specific documents relating to patient treatment and ...

Healthrise

AR Specialist

Farmington, MI · On-site

$20 - $26.25/hr

Reviews, researches, and resolves payment delays and/or variances resulting from rejected and/or ... denials (coding errors, eligibility issues, missing documentation, etc.) and works with clinical ...

Healthrise

Manager, Coding Denials

Farmington, MI · On-site

This individual works closely with Clinical Documentation Integrity (CDI) staff and coordinates ... Conducts performance reviews and regular coaching and leads onboarding and training for new coding ...

PARKSIDE INC

Utilization Review Specialist

Tulsa, OK · On-site

... denials • Performs audits of clinical services to ensure compliance with standards of third party pay sources and agency policies. • Tracks unauthorized services and possible recoupment issues.

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Clinical Denials Coding Review Specialist information

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How much do clinical denials coding review specialist jobs pay per hour?

As of Aug 21, 2026, the average hourly pay for clinical denials coding review specialist in the United States is $28.13, according to ZipRecruiter salary data. Most workers in this role earn between $23.08 and $32.69 per hour, depending on experience, location, and employer.

What is the difference between Clinical Denials Coding Review Specialist vs Medical Coder?

AspectClinical Denials Coding Review SpecialistMedical Coder
CertificationsAHIMA or AAPC certifications, specialized in denial reviewAHIMA or AAPC certifications, general coding credentials
Work EnvironmentHealthcare facilities, insurance companies, or billing companies focusing on denial managementHospitals, clinics, or outpatient facilities performing medical coding
Primary FocusReviewing and resolving claim denials related to clinical documentation and codingAssigning accurate medical codes for billing and documentation

The Clinical Denials Coding Review Specialist primarily focuses on analyzing and resolving claim denials related to clinical documentation, requiring specialized knowledge of denial processes. In contrast, a Medical Coder assigns accurate codes to medical records for billing purposes. While both roles require coding certifications, the specialist role emphasizes denial management and review, often in insurance or billing settings, whereas the medical coder's role is broader in medical documentation coding across healthcare providers.

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Clinical Denials Coding Review Specialist jobs near you
Infographic showing various Clinical Denials Coding Review Specialist job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $58,510 per year, or $28.1 per hour.

Coding Specialist

PathGroup

Nashville, TN • On-site

Full-time

Re-posted yesterday

PathGroup rating

7.3

Company rating: 7.3 out of 10

Based on 58 frontline employees who took The Breakroom Quiz

75th of 120 rated laboratories

Job description

JOB SUMMARY:
The Coding Specialist has knowledge of RCM denial management to resolve coding-related third party payor denials. Coding Specialists increase and expedite service revenue, reduce aged AR, and trend denials for their root causes thereby driving efficiencies, to include documentation improvement and coding denials prevention.
JOB RESPONSIBILITIES
ESSENTIAL FUNCTIONS:
  • Performs front-end review of client documentation to ensure the client has provided documentation that supports the requested services. Review requisitions to ensure the claim is billed accurately.
  • Analyze invalid denial trends, payer-specific carrier submission requirements & system optimization.
  • Performs retrospective coding and documentation review of denied charges. Reviews medical records for completeness and accuracy to ensure documentation supports the services billed and all documentation standards are met for billing and works with referring providers to obtain additional information as needed.
  • Performs extensive follow-up to investigate and resolve payment denial trends.
  • Ensures denial reviews are conducted on time.
  • Participates in annual and ongoing mandatory employee training. Fulfills Continuing Education Units necessary to maintain certification status.
  • Meets productivity standards, identify any issues or trends and bring them to the attention of management.
  • Demonstrates excellent interpersonal, verbal and communication skills.
  • Follows coding guidelines and legal requirements to ensure compliance with our Institutional, federal, and state regulations.
  • Demonstrates the ability to function independently, and use critical thinking and analytical skills.
  • Performs all job responsibilities in alignment with the industry's best security practices and regulatory guidelines to protect the confidentiality, integrity, and availability of protected health information and other sensitive company data.
  • Must be familiar with and abide by the Corporate Compliance Program and all Corporate policies, including the Privacy and Security policies.

NON-ESSENTIAL FUNCTIONS:
  • Work with other departments within PathGroup and subsidiaries.
  • Nothing in the job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
  • Other duties as assigned.

EDUCATION & LICENSURE:
  • High school diploma or GED is required.
  • Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is preferred, not required.
  • Certified from AHIMA or from AAPC preferred, not required.

REQUIREMENTS:
  • Knowledge of CPT and ICD 10 coding experience is preferred
  • Knowledge of governmental payor policies and medical billing experience is preferred.
  • Prior experience working with an eMR systems preferred.
  • Knowledge of third-party reimbursement and payor policies
  • Microsoft Excel and other reporting software to sort, filter, summarize and identify various account receivable trends.

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