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From Home R1 Rcm Medical Coding Jobs in Colorado

cumed

Medical Coding Denial Specialist

Boulder, CO · Remote

This position requires expertise in coding, payer guidelines, medical necessity criteria, and ... individuals from all backgrounds to apply, including protected veterans and individuals with ...

Strive Health

Manager, Coding Operations

Denver, CO · On-site

Hybrid-Remote Flexibility -Work from home while fulfilling in-person needs at the office, clinic ... Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance programs ...

Strive Health

Risk Adjustment Coder

Denver, CO · On-site

$19.25 - $25.75/hr

Hybrid-Remote Flexibility -Work from home while fulfilling in-person needs at the office, clinic ... HCC (Hierarchical Condition Category) Coding, medical coding, clinical terminology and anatomy ...

UCHealth

Mgr Coding

Denver, CO · On-site

$81.79K - $130.83K/yr

... home insurance, and employee discount programs ... Time away from work: Paid time off (PTO), paid family and medical leave (inclusive of Colorado ...

Ernest Health

Coder - Onsite

Johnstown, CO · On-site

$24.41 - $29.17/hr

... from stroke, brain and spinal cord injuries, orthopedic conditions, and other complex medical ... Medical Coding Certification preferred. Additional Qualifications/Skills: * Current knowledge of ...

Children's Hospital Colorado

Medical Coder

Aurora, CO · On-site

$24.48 - $36.72/hr

The Medical Coder provides expert coding support within the Health Information Management (HIM ... from healthcare providers or other designated resources to ensure accurate and complete coding ...

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From Home R1 Rcm Medical Coding information

What are the key skills and qualifications needed to thrive as a Work-from-Home R1 RCM Medical Coder, and why are they important?

To thrive as a Work-from-Home R1 RCM Medical Coder, you need a solid understanding of medical terminology, anatomy, ICD-10/CPT/HCPCS coding systems, and typically a certification such as CPC or CCS. Familiarity with medical billing software, electronic health records (EHR), and compliance tools is essential. Strong attention to detail, time management, and effective communication skills set top performers apart in this role. These competencies ensure accurate claims processing, minimize errors, and support timely reimbursements for healthcare providers.

What are some common challenges faced by remote R1 RCM medical coders, and how can they be addressed?

Remote R1 RCM medical coders often encounter challenges such as maintaining consistent communication with team members, managing time effectively without in-person supervision, and staying updated with frequent changes in coding regulations. Utilizing collaboration tools, participating in regular virtual check-ins, and dedicating time for ongoing learning can help address these issues. Additionally, establishing a dedicated workspace and setting a structured daily routine can significantly improve productivity and work-life balance.

What is a From Home R1 RCM Medical Coding job?

A From Home R1 RCM Medical Coding job involves working remotely for R1 RCM, a revenue cycle management company, to review and assign standardized medical codes to diagnoses and procedures in patient records. Medical coders use systems like ICD-10, CPT, and HCPCS to ensure healthcare providers receive proper reimbursement from insurance companies. Working from home allows for flexible work hours while still maintaining accuracy and compliance with healthcare regulations. This role typically requires specialized training in medical coding and may require certification.

What is the difference between From Home R1 Rcm Medical Coding vs R1 Rcm Medical Billing?

AspectFrom Home R1 Rcm Medical CodingR1 Rcm Medical Billing
CertificationsCPMA, CPC, CCSCPC, CPC-H, CCS
Work EnvironmentRemote, home-basedRemote or office-based
Industry UsageHealthcare, insurance claimsHealthcare, billing and collections
Job FocusAssigning medical codes for diagnoses and proceduresProcessing patient bills and insurance claims

From Home R1 Rcm Medical Coding primarily involves assigning accurate medical codes for diagnoses and procedures, often working remotely. R1 Rcm Medical Billing focuses on managing patient billing, submitting claims, and collections. While both roles are essential in healthcare revenue cycle management, coding emphasizes documentation accuracy, whereas billing centers on financial transactions.

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From Home R1 Rcm Medical Coding jobs near you

Medical Coding Denial Specialist

CU Medicine

Aurora, CO • Remote

Full-time

This job post has expired today. Applications are no longer accepted.

Job description

University of Colorado Medicine (CU Medicine) is the region's largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado.
We are seeking a detail-oriented and highly motivated Coding Denial Specialist to join our Accounts Receivable Resolution team. This role plays a critical part in protecting and optimizing revenue for CU Medicine providers by ensuring surgical claims are accurately reviewed, appealed, and resolved.
This position offers the flexibility of being 100% remote, and qualified out-of-state candidates are encouraged to apply.
The Denial Specialist is an advanced-level billing role within the revenue cycle team, responsible for resolving the organization's most complex insurance denials. This position requires expertise in coding, payer guidelines, medical necessity criteria, and revenue cycle workflows. The Denial Specialist plays a critical role in maximizing reimbursement by analyzing, appealing, and high-complexity claims while maintaining strict quality and productivity standards.
Essential Duties:
Complex Denial Management

  • Investigate, analyze, and resolve advanced denial categories, including:
    • CPT and HCPCS coding denials
    • Modifier-related denials
    • Diagnosis-related denials
    • Bundling and NCCI edits
    • Medical necessity denials
  • Interpret Explanation of Benefits (EOBs) and payer correspondence to determine root causes.
  • Prepare and submit detailed, well-supported written appeals.
  • Recommend appropriate coding corrections, rebilling strategies, or write-offs when warranted.
Medical Necessity Review
  • Abstract and analyze procedure notes, clinical documentation, and patient history.
  • Compare documentation against payer medical policies and coverage determinations.
  • Articulate clearly and persuasively, in writing, when clinical and coding guidelines have been met.
  • Collaborate with leadership and internal teams when documentation clarification is required.
Coding & Compliance Expertise
  • Apply in-depth knowledge of CPT, HCPCS, ICD-10-CM, and modifier guidelines.
  • Ensure alignment with national coding standards and CPC best practices.
  • Identify when coding revisions are appropriate and compliant.
  • Maintain strict adherence to regulatory and payer requirements.
Quality, Productivity & Performance Standards
  • Meet or exceed stringent quantity and quality benchmarks.
  • Maintain high first-pass resolution and successful appeal rates.
  • Ensure accurate documentation of all account activity within the billing system.
Trend Analysis & Process Improvement
  • Identify denial and rejection trends across payers, providers, and service lines.
  • Provide data-driven recommendations to prevent recurring denials.
  • Partner with analyst and leadership to implement corrective action plans.
Requirements:
  • Minimum of 5 years of medical billing and denial management experience.
  • Advanced knowledge of CPT, HCPCS, ICD-10-CM, modifiers, and payer billing guidelines.
  • Strong understanding of medical necessity policies and coverage determinations.
  • Ability to analyze clinical documentation and translate findings into persuasive written appeals.
  • Exceptional written and verbal communication skills.
  • Proven ability to meet strict productivity and quality standards.
  • CPC (Certified Professional Coder) certification preferred.
  • Experience with high-complexity or specialty-specific billing preferred.

All applications MUST be submitted via our website. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.
CU Medicine is an Equal Opportunity Employer and complies with all applicable federal, state, and local laws governing non-discrimination in employment. We are committed to creating a workplace where all individuals are treated with respect and dignity, and we encourage individuals from all backgrounds to apply, including protected veterans and individuals with disabilities.
CU Medicine is dedicated to ensuring a safe and secure environment for our staff and visitors. To assist in achieving that goal, we conduct background investigations for all prospective employees prior to their employment.
The listed pay range (or hiring rate) represents CU Medicine's good faith and reasonable estimate of the range of possible compensation at the time of posting and is based on evaluation of competitive market data.
A variety of factors, including but not limited to, internal equity, experience, and education will be considered when determining the final offer.
CU Medicine provides generous leave, health plans and retirement contributions which take your total compensation beyond the number on your paycheck. Find information about our benefits here.
CU Medicine will post all jobs for a minimum of 7 days or until 250+ applicants have been received (whichever comes first).

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