Remote Medical Coding Denial Specialist

Practice Resources, LLC (PRL) seeks a full-time Remote Coding Denial Specialist.

Job Description:

· Review denied claims to identify patterns and trends in denials.

· Analyze the reason for denials, including coding errors, lack of documentation, and payer policy issues.

· Determine the root cause of denials and recommend corrective actions.

· Develop and submit appeals for denied claims, ensuring proper documentation and justification.

· Follow up on appeals and track their outcomes.

· Maintain records of appeals and their results.

· Be responsible for overseeing denial reports and assigning coding denial appeals.

· Participate in coding team meetings and serve as a subject matter expert.

· Participate in payer meetings to review trends and patterns in payer denials.

· Use relevant policies, procedures, and individual judgment to determine whether events or processes comply with laws, regulations, and standards.

· Provide guidance and support to coders on coding issues.

· Participate in coding audits and quality improvement initiatives

· Be self-motivated and able to work independently, multi-task, problem solve, and make informed and accurate recommendations to medical professionals based on current information.

· Communicate with payers, providers, coders and billers regarding denials and appeals.

· Collaborate with other departments, such as billing and revenue cycle management, to improve denial prevention and recovery.

· Identify opportunities to improve coding processes and reduce denials.

· Develop and implement strategies to prevent future denials.

· Maintain productivity standards for assigned work types and uphold company accuracy scores.

Qualifications:

· Medical coding specialist must be a certified coder (AAPC, AHIMA).

· Must have a minimum of 3 years of coding experience.

· Have a thorough knowledge of anatomy and medical terminology.

· Must have a thorough understanding of codebook resources; CPT, HCPCS Level II, and ICD-10-CM.

· Possess excellent communication and interpersonal skills.

· Understanding healthcare reimbursement processes.

· Excellent analytical and problem-solving skills.

· Ability to work independently and as part of a team.

· Experience with payer websites and appeal processes.

Practice Resources LLC offers a competitive salary and benefits package, including health, dental, vision, disability and life insurance, 401K/Roth 401K options, PTO and flex spending. This is a remote position, with flexible hours after the training period, that allows you to manage a healthy work-life balance. The pay range for this position is $18.00-$30.00 per hour.

Salary : $18 - $30