Join Our Team as a Coding Denial Specialist
Are you passionate about improving the healthcare revenue cycle and ensuring accurate, compliant coding and billing practices? We're looking for a detail-oriented, collaborative, and dedicated
Coding Denial Specialist to join our team. In this role, you'll play a key part in identifying, preventing, and resolving coding-related denials while supporting compliance initiatives and driving continuous process improvement.
As a valued member of the team, you'll work closely with Coding, Professional Billing, Compliance, and Information Technology to ensure billing accuracy, regulatory compliance, and an efficient revenue cycle.
What You'll Do
- Review, research, and resolve coding-related claim denials to support timely reimbursement.
- Identify denial trends and recommend strategies to prevent future coding denials.
- Assist the Coding Compliance Officer with RAC, CERT, payer, and other external coding audits.
- Ensure compliance with federal and state regulations, payer guidelines, and organizational policies.
- Collaborate with Information Technology and Revenue Cycle teams to ensure billing system accuracy and stability.
- Identify revenue cycle opportunities for improvement and recommend process enhancements for Professional Billing.
- Provide coding and denial management expertise to internal departments.
- Train and educate Resolute Billing staff on navigating billing screens, interpreting documentation, and utilizing system notes to improve workflow and accuracy.
- Maintain current knowledge of coding guidelines, payer requirements, and regulatory changes.
- Perform additional duties and special projects as assigned.
Qualifications
Required
- High school diploma or GED.
- Five (5) years of professional billing and coding experience.
- Certified Professional Coder (CPC) or Certified Coding Associate (CCA) credential.
- Valid driver's license and reliable transportation to travel to office locations for training as needed.
- Strong analytical, problem-solving, and organizational skills.
- Excellent communication and collaboration skills.
Preferred
- Bachelor's degree.
- Experience with denial management and appeals.
- Knowledge of Professional Billing revenue cycle processes.
- Experience supporting coding compliance initiatives and payer audits.
- Familiarity with Epic Resolute or similar professional billing systems.
What Makes You Successful
The ideal candidate is someone who:
- Has a strong understanding of professional coding, billing, and denial management.
- Demonstrates attention to detail while maintaining productivity and accuracy.
- Effectively analyzes complex coding and billing issues to identify practical solutions.
- Communicates clearly with colleagues across departments and provides effective education and training.
- Embraces continuous improvement and helps strengthen compliance, billing accuracy, and revenue cycle performance.
If you're committed to coding excellence, regulatory compliance, and improving the healthcare revenue cycle, we encourage you to apply and become part of our team.
Midtown Campus
Patient Financial Services
M-F 7:00AM-3:30PM
Coding Denial Specialist
Equal Opportunity Employer
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