Dispute Coding Analyst: Claims Denials & Audits

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

Job summary

A healthcare organization in Houston seeks a candidate to review provider claims denials, conduct audits, and resolve billing disputes. The ideal candidate has over 2 years of experience in medical coding, holds a CPC or CCS certification, and has strong attention to detail. This position is essential for ensuring compliance with billing standards and improving internal processes. Competitive hourly compensation is offered based on experience and location.

Benefits

Competitive benefits

Equal Opportunity Employer

Qualifications

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

Responsibilities

• Review provider claims denials based on documentation.
• Conduct audits of non-medical records for billing accuracy.
• Generate and communicate determinations to providers.
• Document and communicate coding errors or inconsistencies.
• Complete data points for auditing requirements.
• Enhance departmental processes for compliance.

Skills

Medical coding or billing experience

Attention to detail

Microsoft Office proficiency

Education

Certified Professional Coder (CPC) certification

Certified Coding Specialist (CCS) certification

Job description

A healthcare organization in Houston seeks a candidate to review provider claims denials, conduct audits, and resolve billing disputes. The ideal candidate has over 2 years of experience in medical coding, holds a CPC or CCS certification, and has strong attention to detail. This position is essential for ensuring compliance with billing standards and improving internal processes. Competitive hourly compensation is offered based on experience and location.