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
About AAPC:
AAPC (www.aapc.com) is the world’s largest and fastest-growing training, certification, and solutions association in healthcare.
AAPC Values:
DRIVEN | Self-starts and stays highly motivated to achieve ambitious goals. Shares contagious energy and enthusiasm liberally. Takes initiative without always being directed. Demonstrates confidence in decision-making and effectively balances autonomy and authority with accountability.
HUMBLE | Learns, adapts, and improves relentlessly. Seeks feedback without insecurity and implements coaching. Recognizes others' contributions gratefully. Approaches work and relationships with an abundance mentality. Places the needs of others above self.
TRANSPARENT| Integrity-centered, honest, truthful, and trustworthy in all aspects of work. Keeps commitments to external and internal parties. Holds self strictly accountable, valuing the trust placed in them by others.
SUPPORTIVE | Empowers and uplifts others. Listens actively and responds with empathy and understanding. Prioritizes well-being and growth of team members and customers ahead of own interest. Faces challenges together, believing in collective strength and unity.
INNOVATIVE | Entrepreneurial spirit with a scrappy mentality. Dreams big, sees opportunity, pursues full potential, and finds ways to accomplish the impossible. Rolls up sleeves and does real work. Works quickly, intelligently, and flexibly.
AAPC is an Equal Opportunity Employer.
This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, disability, religion, national origin or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above listed items. We are an Equal Opportunity Employer.
We are an Equal Opportunity Employer. This company does not and will not discriminate in employment and personnel practices on the basis of race, sex, age, disability, religion, national origin, or any other basis prohibited by applicable law. Hiring, transferring and promotion practices are performed without regard to the above-listed items.