CODING DENIALS SPECIALIST

Pella Regional Health Center; Pella (IA); On-site; USD 60,000 - 80,000; Full time

Job summary

Pella Regional Health Center is seeking a coder with expertise in revenue integrity to analyze coding edits and denials within the billing scrubber. You will write appeals and work with clinical departments and the business office to identify denial patterns and opportunities.

The role requires a strong understanding of coding guidelines, NCCI edits, CMS regulations, and payer edits, along with the ability to read and interpret EOBs.

Qualifications

• Experience analyzing coding edits and denials.
• Ability to read and understand EOBs and payer notes.
• Familiarity with coding guidelines, CMS rules, and denials trends.

Responsibilities

• Analyze and investigate coding edits and denials within the billing scrubber.
• Write appeals and collaborate with clinical departments and business office on denial patterns and opportunities.
• Demonstrate strong understanding of coding guidelines, NCCI edits, CMS regulations, and payer edits.
• Read and understand EOBs and communicate findings clearly.
• Demonstrate strong communication skills, critical thinking, and ability to multi-task within the department.

Skills

Coding guidelines

NCCI edits

CMS regulations

EOB interpretation

Appeals writing

Job description

Job Summary

This position reports to the Revenue Integrity & Coding Supervisor under the direction of the Director of Revenue Cycle. Responsibilities include analyzing and investigating coding edits and denials within the billing scrubber. Proficient in writing appeals and collaborating with clinical departments and business office on denial patterns and opportunities. Strong understanding of coding guidelines, NCCI edits, CMS regulations, payer edits, and the ability to read and understand EOBs. Strong communication skills and able to critically think through processes. Ability to multi-task and float within the department and complete any duties as assigned.