Medical Coding Specialist — Front-End Claims & Denials

Innovaccer Analytics; Oregon; Hybrid; USD 65,000 - 95,000; Full time

Benefits offered by this job

20 days Paid Time Off

Generous parental leave

Rewards & recognition program

Comprehensive insurance coverage

Job summary

Innovaccer Inc. seeks a Medical Coding Specialist to independently review, analyze, and resolve front-end scrubs and denied claims to ensure accurate and timely payments.

You will correct coding issues before submission, resubmit corrected claims or appeals, and apply coding guidelines with attention to privacy and compliance. You will work closely with revenue cycle partners to prevent rejections and support clean claim rates, maintaining high coding accuracy 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 reimbursement 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 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 and resolve front-end scrubs and denied claims.
• Assign ICD-10-CM and CPT codes with appropriate modifiers.
• Review medical records to determine proper codes for services and diagnoses.
• Ensure diagnosis codes meet local and national medical necessity guidelines.
• Create appeal letters/forms with medical documentation.
• Resubmit corrected claims or appeals as needed.
• Maintain coding accuracy; target minimum 92% accuracy.
• Escalate trends to Coding Manager and attend team meetings.
• Research and apply payer guidelines and internal policies.
• Protect patient information per HIPAA regulations.

Skills

CPT/ICD-10-CM knowledge

Attention to detail

Communication skills

Independent judgment

Documentation standards

Analytical thinking

HIPAA compliance

Education

AAPC or AHIMA Coding Certification

Tools

Microsoft Office Suite

Job description

Innovaccer Inc. seeks a Medical Coding Specialist to independently review, analyze, and resolve front-end scrubs and denied claims to ensure accurate and timely payments.

You will correct coding issues before submission, resubmit corrected claims or appeals, and apply coding guidelines with attention to privacy and compliance. You will work closely with revenue cycle partners to prevent rejections and support clean claim rates, maintaining high coding accuracy in a fast-paced environment.