Medical Coding Denials Specialist - Contractor

This is a remote role

We are seeking a highly motivated and dedicated coding professional to join our team as a contracted medical coding denials specialist. This position is remote. The ideal candidate must have at least 5 years of coding experience in the professional, surgical realm. As well as 3 years’ experience with working denials, recoding/validating codes and working claim edits. The position requires one to be resourceful, organized, independent, and extremely driven.
Job Duties:

• Review and analyze coding related denials and rejections from insurance payers
• Identify root causes of denials, such as incorrect coding, missing information, or insufficient documentation
• Prepare appeal letters to insurance companies, ensuring accurate, compliant, and complete responses to denials
• Conduct thorough audits of medical records and claims to ensure accurate coding in compliance with ICD-10, CPT, and HCPCS guidelines
• Identify trends in coding denials
• Follow current ICD-10 and CPT coding guidelines
• Adhere to NCD, LCD, and CCI policies as necessary
• Apply modifiers as appropriate
• Stay updated about new coding rules as codes routinely change
• Responsible and accountable for maintaining the confidentiality, integrity, and availability of protected health information. Follow HIPAA security policies and procedures affecting your job, and report any suspected or actual violation or breach
• Requires long periods of time sitting and using keyboard and mouse
• Meet and maintain department production and quality standards
• Additional tasks/duties as assigned by management

• Education: High school diploma or equivalent required; Associate or Bachelor’s degree in Health Information Management, Medical Billing and Coding, or a related field preferred.
• Certifications: Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or equivalent coding certification required
• Experience: Minimum of 5 years of experience in medical coding. Minimum of 3 years denial management experience
• Skills:
  • Strong understanding of ICD-10, CPT, HCPCS coding systems, and payer-specific guidelines.
  • Knowledge of medical terminology, healthcare billing processes, and insurance claim adjudication.
  • Excellent analytical and problem-solving skills.
  • Effective written and verbal communication skills for interacting with healthcare providers, payers, and team members.
  • Proficiency with healthcare billing software, electronic medical records (EMR), and Microsoft Office Suite.
  • Ability to multitask and keep a sense of urgency
  • Strong time management, organization skills, and work ethic
  • Ability to work independently