Coding Denial and Resolution Specialist FTE, Day Shift, Remote

Employer Industry: Healthcare Services

• Opportunity for career advancement and growth within the organization
• Work remotely from approved states
• Collaborative work environment focused on coding best practices
• Chance to make a positive impact on reimbursement accuracy and denial prevention
• Engage with various teams to enhance coding and billing processes

• Review and triage post‑billed coding denials and rejections for hospital and medical group claims
• Validate denial rationale using remittance advice, payer policies, and coding guidelines
• Perform medical record reviews to ensure accurate code selection and documentation support
• Draft, submit, and track appeals and reconsiderations in compliance with payer requirements
• Analyze denial trends and prepare reports to communicate findings to stakeholders

• Associate’s Degree in Health Information Management, Business, or related field, or equivalent combination of education and experience
• Current coding certification: CCA, CPC, CCS, CCS‑P, CPMA, RHIA, or RHIT
• Three (3) years of experience in advanced hospital and professional coding
• Knowledge of ICD‑10, CPT, HCPCS, modifiers, and coding guidelines
• Proficiency with Microsoft Office applications, including advanced Excel, Word, and PowerPoint skills

• Bachelor’s Degree in Health Information Management, Business, or related field
• Two (2) years of experience in coding denial management or related denial resolution work
• Certified Professional Medical Auditor (CPMA)
• Experience with Epic and 3M systems
• Familiarity with payer portals and denial/appeals tracking tools