Dispute Coding Analyst: Claims Denials & Audits

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

Job summary

A healthcare organization based in Des Moines, Iowa is seeking a candidate to support dispute resolution related to provider appeals. The ideal candidate will have at least 2 years of experience in medical coding or billing and hold a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification. Responsibilities include reviewing claim denials, conducting audits, and improving departmental processes. This position offers competitive compensation and a focus on quality standards.

Benefits

Competitive benefits and compensation package

Qualifications

• At least 2 years of experience in medical coding or billing.
• Active and unrestricted Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification.
• Strong attention to detail and ability to independently read and comprehend the details of medical records.
• Comfortable working in a production-centric environment with high quality standards.
• Ability to use Microsoft Office including Outlook, Word, and Excel.

Responsibilities

• Reviews coding-related provider claims denials by examining medical records and submission history.
• Conducts audits of non-medical records to verify billing accuracy.
• Generates and communicates determinations to providers.
• Identifies and documents coding errors, collaborating with internal departments.
• Completes data points within internal applications for auditing compliance.
• Participates in enhancing departmental processes to align with coding regulations.

Skills

Attention to detail

Medical coding

Medical billing

Microsoft Office

Education

Certified Professional Coder (CPC)

Certified Coding Specialist (CCS)

Job description

A healthcare organization based in Des Moines, Iowa is seeking a candidate to support dispute resolution related to provider appeals. The ideal candidate will have at least 2 years of experience in medical coding or billing and hold a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification. Responsibilities include reviewing claim denials, conducting audits, and improving departmental processes. This position offers competitive compensation and a focus on quality standards.