Coding Analyst Denials Appeals

CommonSpirit Health; Phoenix (AZ); On-site; USD 60,000 - 80,000; Full time

Job summary

Dignity Health Medical Group (DHMG) is seeking a Coding Analyst Denials Appeals to review records for coding accuracy and correct diagnostic and procedural codes in the billing system to ensure proper reimbursement. You will analyze complex data daily and stay current with coding standards and healthcare regulations.

Responsibilities include investigating denials across specialties, submitting corrected claims and appeals, and communicating trends to management while ensuring compliant billing

Qualifications

• Three years of medical coding and/or billing experience for physician office services
• Proficiency assigning ICD-10-CM, CPT, HCPCS, and modifiers
• Ability to read and comprehend an explanation of benefits (EOB)
• Proficiency with guidelines, CCI, LMRP, coding, and modifiers
• Ability to research CPT/ICD-10 codes to bill appropriately
• Understanding of reimbursement processes and payer policies

Responsibilities

• Review records for coding errors and correct codes for reimbursement
• Submit corrected claims, reconsiderations and appeals to health plans
• Identify payer and system trends and communicate to management
• Maintain knowledge of payer contracts, regulations, and billing laws
• Communicate with coworkers and leadership to meet departmental goals

Skills

ICD-10-CM coding

CPT/HCPCS coding

Modifier assignment

EOB interpretation

Research CPT/ICD10 codes

Reimbursement knowledge

Google Workspace

Education

High School Diploma

Associate degree

Tools

Google Workspace

Job description

Job Summary and Responsibilities

As our Coding Analyst Denials Appeals, you will accurately review records for coding errors and correct diagnostic and procedural codes in billing system for the purpose of reimbursement utilizing ICD-10-CM, CPT, HCPCS, and proper modifiers.

Every day, you will analyze and interpret complex data.

To be successful in this role, you must combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations.

• This is a specialized healthcare professional who utilizes their coding knowledge to investigate, correct and resubmit medical claims that have been rejected or denied by an Insurance company. The employee works coding related denials for multiple specialties across the market. Accurately reviewing medical records for coding errors and when appropriate, corrects modifiers, ICD-10, CPT, or HCPCS codes in the practice management system for the purpose of accurate coding. Submits corrected claims, reconsiderations and appeals to the health plan. Must be able to identify and communicate payer and/or system trends to Management. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection practices to ensure accurate and compliant billing processes. Clearly communicate with coworkers, leadership and outside organizations to meet our departmental goals and ensure timely reimbursement.

Job Requirements

Required

• High School Graduate


• Three (3) years prior experience in medical coding and/or billing for physician office services


• Proficiency assigning ICD-10-CM , CPT, HCPCS ,and modifiers


• Ability to read and comprehend an EOB


• Proficient in guidelines, CCI, LMRP, coding, use of modifiers


• Ability to research CPT/ICD10 codes to bill appropriately


• Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules)
  


• Adept in physician and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment
  compliance, denials and appeals recovery


• Proficient understanding of medical coding systems effecting the adjudication of claims payment


• Proficiently utilizes Google Workspace

One of the following Certifications:

• Certified Professional Coder, (CPC)


• Certified Professional Coder Apprentice (CPCA)


• Certified Coding Specialist (CCS)


• Certified Coding Specialist - Physician Based (CCS-P)


• Certified Cardiovascular and Thoracic Surgery Coder (CCVTC)


• Certified Health Care Compliance (CHC)


• Certified Interventional Radiology Cardio Coder (CIRCC)


• Radiology Certified Coder (RCC)


• Registered Health Information Administrator (RHIA)


• Registered Health Information Technician (RHIT)

Preferred

• Associates degree


• Five (5) years work experience in medical billing and coding for physician office services

Where You'll Work

Hello Humankindness

Where Your Passion Meets Purpose: Join Dignity Health Medical Group

Are you a healthcare professional who believes that every patient deserves not just treatment, but unwavering compassion? Do you envision a world where healthcare isn't just a service, but a fundamental right, delivered with integrity and innovation? If so, then Dignity Health Medical Group (DHMG) is where your career finds its true calling.

At Dignity Health Medical Group, you're not just filling a role; you're becoming an architect of healthier communities. We are the employed physician group of Dignity Health Arizona, and our success isn't just measured in numbers, but in the lives we touch and the advancements we champion.

Here's what sets us apart and why you belong with us:

• Impact that Resonates: You'll be part of a team delivering comprehensive clinical services, making a tangible difference in the lives of countless individuals. From cutting-edge diagnostics to life‑changing treatments, your expertise will directly contribute to improved health outcomes.


• A Culture of Growth and Innovation: We don't just practice medicine; we advance it.


• Shaping the Future of Healthcare: DHMG is deeply invested in preparing tomorrow's healthcare providers. We seamlessly blend clinical services with translational and bench research, creating a dynamic environment that augments medical education for residents and students.


• Values-Driven Mission: We are united by a powerful set of principles. If you are deeply committed to social justice, health equity, and are prepared to deliver care in new, innovative ways, your values align perfectly with ours. We believe that everyone, regardless of background, deserves access to high‑quality healthcare, and we actively work to make that a reality.


• A Supportive and Collaborative Environment: We believe in building a strong, inclusive team where everyone feels valued and respected.

Are you ready to transcend the ordinary and join a healthcare family where your skills are celebrated, your voice is heard, and your passion for healing finds its ultimate expression?

If you're eager to contribute to an organization that is making a profound difference, where innovation meets compassion, and where your commitment to social justice and health equity will be not just welcomed, but celebrated – then Dignity Health Medical Group is waiting for you.