Medical Coder: Front-End Claims & Denials

Innovaccer Inc.; United States; Remote; USD 55,000 - 90,000; Full time

Benefits offered by this job

Paid time off 20 days

Parental leave

Recognition rewards

Medical insurance

Job summary

Innovaccer Inc. is seeking a Medical Coder to independently review, analyze, and resolve front-end scrubs and denied claims, ensuring accurate and timely payments. You will assign ICD-10-CM and CPT codes, prepare appeals, and maintain high coding accuracy while adhering to HIPAA guidelines.

You will collaborate with revenue cycle partners, stay current with payer policies, and contribute to efficient reimbursement processes in a fast-paced environment.

Qualifications

• Must hold a current AAPC or AHIMA Coding Certification for a minimum of 3 years.
• Minimum of 3+ years of professional coding experience.
• Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare guidelines.
• Prior experience in reviewing front end coding errors before submitting to insurance
• Prior experience in reviewing and correcting coding from insurance denials.
• Prior experience in submitting corrected claims and appeals.
• Prior experience with insurance guidelines and EOBs.
• Familiarity with proper English grammar, usage, and professional documentation standards.
• Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues.
• Ability to read, interpret, and apply policies, procedures, laws, and regulations.
• Demonstrated ability to exercise independent judgment in coding and claim resolution.
• Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff.
• Strong commitment to maintaining confidentiality and safeguarding protected health information.
• Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements.
• Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).

Responsibilities

• Review front-end scrubs/denials and resolve claims to ensure timely payment.
• Analyze documentation to assign ICD-10-CM and CPT codes with modifiers.
• Prepare appeal letters/forms with medical documentation.
• Maintain minimum 92% coding accuracy.
• Review medical records to determine appropriate codes for documented services.
• Ensure codes meet local and national medical necessity guidelines.
• Research payer guidelines and internal resources for accurate coding.
• Follow HIPAA regulations and protect patient information.
• Escalate client trends to Coding Manager and discuss with team leads.
• Complete CEU requirements and participate in meetings.

Skills

Attention to detail

Independent worker

Excellent communication

Analytical thinking

Education

AAPC or AHIMA Coding Certification

Tools

Microsoft Office

Job description

Innovaccer Inc. is seeking a Medical Coder to independently review, analyze, and resolve front-end scrubs and denied claims, ensuring accurate and timely payments. You will assign ICD-10-CM and CPT codes, prepare appeals, and maintain high coding accuracy while adhering to HIPAA guidelines.

You will collaborate with revenue cycle partners, stay current with payer policies, and contribute to efficient reimbursement processes in a fast-paced environment.