Clinical Coding Analyst: Denials & Audits Specialist

Health Business Solutions LLC; Cebu City; On-site; PHP 334,800 - 558,000; Full time

Job summary

A healthcare solutions firm is seeking a Clinical Coding Analyst to review and analyze denied claims, support coding appeals, and conduct audits to validate coding practices. The ideal candidate has a Bachelor's degree in Nursing or a related field, holds relevant certifications, and possesses at least 2-3 years of coding experience. Proficiency in coding software and effective communication skills are essential to collaborate with cross-functional teams. This role offers the opportunity to improve healthcare delivery through accurate coding practices.

Qualifications

• Minimum of 2-3 years of medical coding or auditing experience.
• Experience with risk adjustment audits and payer audits.
• Familiarity with medical necessity criteria and reimbursement methodologies.

Responsibilities

• Review and analyze claims that have been denied due to coding-related issues.
• Prepare and support coding-based appeals with clinical justifications.
• Conduct in-depth coding audits and validate coding practices.

Skills

Knowledge of ICD-10

Knowledge of CPT

Knowledge of HCPCS

Detail-oriented mindset

Effective communication skills

Education

Bachelor's degree in Nursing or related field

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Certified Inpatient Coder (CIC)

Tools

Coding software

Electronic Health Record (EHR) systems

Job description

A healthcare solutions firm is seeking a Clinical Coding Analyst to review and analyze denied claims, support coding appeals, and conduct audits to validate coding practices. The ideal candidate has a Bachelor's degree in Nursing or a related field, holds relevant certifications, and possesses at least 2-3 years of coding experience. Proficiency in coding software and effective communication skills are essential to collaborate with cross-functional teams. This role offers the opportunity to improve healthcare delivery through accurate coding practices.