Dispute Coding Analyst: Claims Denials & Audits

Molina Healthcare; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare provider in Albuquerque seeks a detail-oriented professional to support provider appeals resolutions. The candidate should have at least 2 years of medical coding or billing experience and hold an active CPC or CCS certification. Responsibilities include reviewing claims denials, conducting audits, and communicating determinations to providers. Molina Healthcare offers a competitive hourly pay range of $21.82 - $51.06, depending on experience and skills.

Qualifications

• At least 2 years of experience in medical coding or billing.
• Active and unrestricted CPC or CCS certification.
• Strong ability to read and comprehend medical records.

Responsibilities

• Review coding-related provider claims denials systematically.
• Conduct independent audits of non-medical records.
• Generate and communicate determinations to providers.
• Document and communicate coding errors or inconsistencies.
• Complete data points within internal applications.
• Enhance departmental processes to maintain coding compliance.

Skills

Attention to detail

Medical coding knowledge

Microsoft Office proficiency

Production-centric work capability

Education

Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)

Job description

A leading healthcare provider in Albuquerque seeks a detail-oriented professional to support provider appeals resolutions. The candidate should have at least 2 years of medical coding or billing experience and hold an active CPC or CCS certification. Responsibilities include reviewing claims denials, conducting audits, and communicating determinations to providers. Molina Healthcare offers a competitive hourly pay range of $21.82 - $51.06, depending on experience and skills.