REMOTE position. - in the following states: AL, AZ, AK, GA, FL, IA, IN, IO, KS, LA, MS, MO, MT, NC, OH, OK, SC, SD, TN, TX, UT, VA, WY

Position Highlights:

This role is responsible for analyzing coding denials by Payer, CPT code(s), and specialty area, review and submission of coding appeals related to denials to include coding, bundling, duplicate, and other assigned denial volume. As well as responsible for the coordination and management of timely insurance claim follow-up including identifying, monitoring, appealing, and resolving denied claims and accounts in the Aged Trial Balance.   Perform detailed analysis on denied assigned claims with a focus on maximizing revenue and reimbursement.

Responsibilities:

• Review and analyze  coding, bundling, and duplicate denials including identification of root cause.
• Resolve coding denials which include researching and reviewing payer coding guidelines, writing and submitting appeals with supporting documentation.
• Analyzing assigned denials and making necessary corrections or modifications.
• Make a preliminary determination whether denial can be overturned and if initial or secondary appeals should be submitted.
• Identify and provide coding denial trends by Payer, CPT code, or any other denial parameters

Credentials and Qualifications:

• Associate degree required.
• A minimum of three (3) years of denial recovery experience or revenue cycle related filed is required
• Must be able to complete Root Cause Analysist on assigned denials.
• CPC- Certified Professional Coder required

* "in lieu of" Associate's, a H.S. Diploma with two (2) years of denial recovery experience or revenue cycle related field may be considered.

Preferred

Professional coding experience in a multi-specialty environment, preferably with oncology and/or surgical experience.  Soarian experience.