Insurance Claims Denials Coder & Appeals Expert

The HIRD- USA; Atlanta (GA); On-site; USD 60,000 - 80,000; Full time

Job summary

A healthcare insurance company located in Atlanta, Georgia, seeks a coding specialist to review and analyze denied medical claims. Candidates must possess valid CPC or CCS certification and have extensive experience in the insurance industry. The responsibilities include conducting coding audits and ensuring compliance with reimbursement guidelines. This role requires excellent analytical skills and attention to detail for documenting audit findings and recommendations.

Qualifications

• Certified & active Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required.
• 2-3 years of prior E&M/GMC experience.
• Minimum 3 years experience reviewing denied claims and performing coding audits.

Responsibilities

• Review adjudicated medical claims that have been denied and resubmitted for reconsideration.
• Analyze claim documentation and medical record details for validity of denial reasons.
• Conduct detailed coding audits to validate proper code assignment.

Skills

Attention to detail

Analytical skills

Communication skills

Coding accuracy

Education

CPC or CCS certification

Job description

A healthcare insurance company located in Atlanta, Georgia, seeks a coding specialist to review and analyze denied medical claims. Candidates must possess valid CPC or CCS certification and have extensive experience in the insurance industry. The responsibilities include conducting coding audits and ensuring compliance with reimbursement guidelines. This role requires excellent analytical skills and attention to detail for documenting audit findings and recommendations.