Claims Compliance & Denials Specialist

Billings Clinic; Billings (MT); On-site; USD 33,000 - 41,000; Full time

Job summary

Billings Clinic is seeking a detail-oriented Coding Resources specialist to analyze pre-bill scrubber edits, denials, and review requests. You will ensure coding accuracy in line with CPT-4/HCPCS, ICD-10-CM guidelines, and payer regulations, while educating the team on findings and best practices.

The role involves collaborating with multiple departments, appealing denials, and supporting ongoing audits to maximize reimbursement and maintain compliance.

Qualifications

• High school graduate or equivalent.
• RHIT or RHIA certification, CPC or CCS, or AHIMA/AAPC equivalent.
• Experience with ICD-CM, CPT-4/HCPCS coding, billing, and reimbursement.

Responsibilities

• Researches and analyzes coding-related pre-bill scrubber edits, denials, and review requests.
• Ensure coding compliance with government and third-party payer regulations.
• Appeal denials and follow up with payers until paid.
• Provide education to Coding Resources teams based on audit findings.

Skills

RHIT/RHIA CPC/CCS

ICD-CM CPT-4 HCPCS

Denials appeals

Data analysis

Microsoft Excel

Team collaboration

Regulatory compliance

Education

High school diploma

RHIT or RHIA

CPC or CCS

Tools

Microsoft Word

Excel

PowerPoint

Job description

Billings Clinic is seeking a detail-oriented Coding Resources specialist to analyze pre-bill scrubber edits, denials, and review requests. You will ensure coding accuracy in line with CPT-4/HCPCS, ICD-10-CM guidelines, and payer regulations, while educating the team on findings and best practices.

The role involves collaborating with multiple departments, appealing denials, and supporting ongoing audits to maximize reimbursement and maintain compliance.