Returned Claims Coding Specialist (Remote)

Title:
Returned Claims Coding Specialist - FQHC

Location:
Remote- USA

Reports to:
Director, Revenue Cycle Operations

FLSA Classification:
Non-Exempt

Full-Time or Part-Time:
Full-Time

Salary Range:
$24 - $28
Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise.

Position Overview:
As a Returned Claims Coding Specialist at Coronis Health, you will play a vital role in improving claim processing outcomes for our FQHC-focused medical billing clients. You will analyze returned claims, identify trends, and collaborate with account managers, the coding team, and other stakeholders to develop strategies to minimize claim errors. Your work will directly impact our commitment to delivering exceptional service and outcomes for our clients.

Key Responsibilities:

• Review returned claim files to identify coding issues, missing information, or system errors.
• Track and analyze claim trends to determine recurring problems.
• Respond to inquiries regarding inappropriate coding, denials, and billable services.
• Prepare and distribute monthly summaries of returned claims trends for clients.
• Collaborate with the Director of FQHC Compliance, Coding, & Client Regulatory Education to provide targeted education sessions.
• Partner with account managers to understand payor-specific policies, coding requirements, and claims processing rules.
• Maintain detailed records of returned claims trends, root causes, and corrective actions.
• Provide regular reports to internal stakeholders to drive continuous improvement.
• Assist in developing workflows to reduce returned claims and enhance coding accuracy.

Qualifications:

• High School diploma or equivalent required; Associate’s or Bachelor’s degree preferred.
• Professional coding certification (e.g., CPC, CCA, CCS, CCS-P) required.
• Minimum of 2 years of work experience in an office setting, with medical billing experience preferred.
• Knowledge of medical coding and billing systems, as well as regulatory compliance requirements.
• Strong analytical, organizational, and communication skills.
• Proficiency in Microsoft Office Suite and familiarity with medical billing software.

Additional Information:

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.