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Akron Children's Hospital

Coding Denial Specialist

Akron, OH · On-site +1

$18 - $23/hr

Full-time, 40 hours/week Monday-Friday 8am-4:30pm Remote Summary: The Denial Coding Specialist ... Experience working in an Electronic Medical Record system preferred * Experience in healthcare is ...

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What are the key skills and qualifications needed to thrive as a Remote Medical Billing RCM (Revenue Cycle Management) Specialist, and why are they important?

A Remote Medical Billing RCM Specialist needs knowledge of medical billing procedures, coding standards (such as ICD-10, CPT, and HCPCS), and a background in healthcare administration or billing certification. Familiarity with billing software, electronic health records (EHR) systems, and claims management platforms is essential, often supplemented by certifications like Certified Professional Biller (CPB) or Certified Revenue Cycle Representative (CRCR). Attention to detail, organization, and strong communication skills help specialists resolve claim issues and interact effectively with patients and payers. These skills ensure accurate claim processing, timely reimbursements, and compliance with regulations—crucial for the financial health of healthcare practices.

What are some common challenges faced by Remote Medical Billing RCM professionals, and how can they be addressed?

Remote Medical Billing RCM (Revenue Cycle Management) professionals often encounter challenges such as keeping up with frequent changes in insurance policies, managing claim denials, and maintaining clear communication with healthcare providers and payers. Working remotely can add complexity, as team collaboration and access to sensitive data must be handled securely and efficiently. Staying organized with a robust workflow, leveraging secure billing software, and participating in regular virtual meetings can help address these challenges and ensure effective revenue cycle management.

What are Remote Medical Billing RCM professionals?

Remote Medical Billing RCM (Revenue Cycle Management) professionals are specialists who manage and optimize the financial processes involved in healthcare billing from a remote location. Their responsibilities include submitting medical claims to insurance companies, following up on unpaid claims, verifying patient insurance coverage, and ensuring accurate coding and billing. By working remotely, they support healthcare providers in maintaining steady cash flow and compliance with industry regulations. These roles typically require knowledge of medical terminology, billing software, and healthcare regulations such as HIPAA. Remote work allows for flexibility while still providing essential support to healthcare organizations.

What is the difference between Remote Medical Billing Rcm vs Remote Medical Coding Specialist?

AspectRemote Medical Billing RcmRemote Medical Coding Specialist
Primary RoleManaging billing processes, submitting claims, and ensuring payment collectionReviewing medical records and assigning appropriate codes for billing and documentation
Required CertificationsCPB, CPC, or similar billing certificationsCPC, CCS, or coding certifications
Work EnvironmentRemote or office-based, healthcare or billing companiesRemote or office-based, healthcare providers or coding companies
Industry UsageWidely used in healthcare billing and revenue cycle managementCommon in medical record documentation and coding departments

While both roles are essential in healthcare revenue cycle management, Remote Medical Billing Rcm focuses on submitting claims and collecting payments, whereas Remote Medical Coding Specialist concentrates on accurately coding medical records. They often collaborate but require different certifications and skill sets.

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What cities in Ohio are hiring for Remote Medical Billing Rcm jobs? Cities in Ohio with the most Remote Medical Billing Rcm job openings:
Remote Medical Billing Rcm jobs near you
Coding Denial Specialist

Coding Denial Specialist

Akron Children's Hospital

Akron, OH • On-site, Remote

$18 - $23/hr

Full-time

Posted 14 days ago

Akron Children's Hospital rating

7.3

Company rating: 7.3 out of 10

Based on 93 frontline employees who took The Breakroom Quiz

345th of 989 rated hospitals

Job description

Full-time, 40 hours/week
Monday-Friday 8am-4:30pm
Remote
Summary:
The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. Working closely alongside the Physician Advisor, the Denial Coding Specialist liaises between the Revenue Recovery team and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. This position reports to the Revenue Recovery Supervisor.
Responsibilities:
  1. Performs retrospective account reviews and resolves coding denials accordingly.
  2. Analyzes coding-related denials (e.g., bundling issues and inappropriate CPT/diagnoses) to identify trends and root causes
  3. Proactively maintains current knowledge of applicable regulations, requirements, changes, and best practices by following industry sources (e.g., Centers for Medicare & Medicaid Services, American Association of Professional Coders, and professional journals)
  4. Reviews EPIC work queues daily for Denial management and makes necessary and appropriate coding changes based on medical documentation for both professional and technical charge revenue.
  5. Follows up with providers to resolve outstanding queries for additional documentation or diagnosis information
  6. Coordinates and/or completes appeals as applicable with payors.
  7. Develops suggestions for coding and documentation process improvements, based on denial analysis and industry coding guidelines
  8. Extracts data into clear reports to revenue recover and revenue cycle leadership, physician advisor, and providers
  9. Partners with Revenue Cycle team leaders, physicians, and providers to develop and implement process improvements
  10. Provides regular feedback and ad-hoc education to revenue recovery staff and providers to promote departmental knowledge of appropriate coding practices
  11. Other duties as required.

Other information:
Technical Expertise
  1. Experience in CPT and ICD coding is required.
  2. Experience working with all levels within an organization is required.
  3. Experience working in an Electronic Medical Record system preferred
  4. Experience in healthcare is preferred.
  5. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.

Education and Experience
  • Education: High School Diploma or equivalent is required; Bachelor's degree is preferred.
  • Certification: AAPC or AHIMA Coding Certification is required.
  • Years of relevant experience: 0 to 2 years is preferred.
  • Years of experience supervising: None.

Credentials
Essential (minimum one as applicable):
  • American Academy of Professional Coders
  • American Health Information Management Association
  • Certified Provider Credentialing Specialist
  • Certified Coding Specialist
  • Registered Health Information Technician
  • Certified Coding Associate

Full Time
FTE: 1.000000
Status: Remote

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About Akron Children's Hospital

Sourced by ZipRecruiter

Akron Children's Hospital has been caring for children since 1890, and our pediatric specialties are ranked among the nation's best by U.S. News & World Report. With two hospital campuses, regional health centers and more than 50 primary and specialty care locations throughout Ohio, we're making it easier for today's busy families to find the high-quality care they need. In 2020, our health care system provided more than 1.1 million patient encounters. We also operate neonatal and pediatric units in the hospitals of our regional health care partners. Every year, our Children's Home Care Group nurses provide thousands of in-home visits, and our School Health nurses manage clinic visits for students from preschool through high school. With our Quick Care Online virtual visits and Akron Children's Anywhere app, we're here for families whenever and wherever they need us. Learn more at akronchildrens.org.

Industry

Hospitals

Company size

5,001 - 10,000 Employees

Headquarters location

Akron, OH, US

Year founded

1890

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