PB & HB Coding Edits & Denials Specialist (AAPC or AHIMA Cert. Req.d)

CorroHealth, Inc.; Austin (TX); A distancia; USD 60.000 - 90.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote full-time schedule

Medical, Dental, Vision coverage

Long-term disability insurance

Life insurance

401K with company match

Certification and Tuition Reimbursment

Descripción de la vacante

CorroHealth, Inc. is seeking a certified ProFee coder for a remote, US-based role focused on hospital outpatient/ facility denials, coding compliance, and reimbursement optimization. You will perform denial resolution, payer policy research, coding review, and revenue integrity support.

Applicants must hold CPC/COC or CCS/CCS-P, have at least 6 months of experience, and be proficient with CPT/ ICD-10 coding, EMR systems, and Microsoft Office. Remote work within the continental US is required.

Formación

• Certified ProFee coder through AAPC or AHIMA.
• Minimum 6 months on-the-job coding experience.
• Proficiency with CPT/ICD-10 coding references and EMR systems.

Responsabilidades

• Perform denial resolution for ProFee and Hospital Outpatient (Facility) denials.
• Research payer policies and coding guidelines to support denials management.
• Review and resolve denials in EPIC with high accuracy.
• Ensure coding aligns with AHIMA's Standards of Ethical Coding and company policies.

Conocimientos

Certified ProFee coder

ProFee & Hospital Outpatient denials

Payer policy research

Review denials in EPIC

ICD-10-CM/PCS, CPT/HCPCS

MS Excel & Outlook

Effective communication

Remote work readiness

Educación

AAPC CPC/COC or AHIMA CCS/CCS-P

Herramientas

EPIC

Microsoft Excel

Outlook

Descripción del empleo

About Us

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

Job Summary

Join one of CorroHealth's most established and successful teams, supporting long-term client partnerships through coding excellence. We're seeking a certified ProFee coder who thrives in a remote, autonomous environment and who also has expertise in hospital outpatient/facility denials, coding compliance, and reimbursement optimization. This role combines hands‑on denial resolution, payer policy research, coding review, and revenue integrity support, making it ideal for an experienced coder who enjoys solving complex reimbursement challenges while maintaining exceptional quality and productivity standards. This is a remote position.

Essential Duties and Responsibilities

Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member. This is a remote position. Permanent work status (USC/Greencard) is required. Employees must reside within and work within the continental U.S. Candidates will be required to complete a proctored Profee Coding assessment as part of the application process.

Responsibilities

• Team Member must be able to work from home and be independent in their coding skills.
• Provide various components of coding services to support our clients.
• Strong experience in ProFee and Hospital Outpatient (Facility) denials.
• Understanding of Remit & CARC codes.
• Review and resolve denials in EPIC.
• Research payer policies.
• Identify trending denial issues that can be escalated to management.
• Resolve Medical Necessity and CCI edits.
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.
• Apply ICD‑10‑CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis codes utilizing ICD‑10‑CM, ICD‑10‑PCS, CPT®, and HCPCS.
• Interpret coding guidelines for accurate code assignment.
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct and support the Company’s Ethics and Compliance Program.
• Comply with all internal policies and procedures.
• Actively participate in Company provided training and education.
• All Coders must maintain at least one credential through either AAPC or AHIMA.
• Ensure individual compliance with all privacy and security rules and regulations and commit to the protection of all Company confidential information, including but not limited to, Personal Health Information.

Minimum Qualifications & Requirements

• All coders MUST be certified through either the AAPC (CPC or COC) or AHIMA (CCS or CCS‑P).
• Must have at least a minimum of 6 months of on‑the‑job experience.
• Regular, predictable, and punctual attendance is required.
• Must have working knowledge and experience with systems such as EMR, Billing, etc.
• Must have a phone, reliable internet connection and current coding materials such as CPT and ICD‑10‑CM coding references.
• Will be required to maintain an ongoing productivity level and accuracy rate of 95% or higher.
• Must be proficient in Microsoft programs like Excel and Outlook.
• Examples include:
  • You should be able to open and add to an Excel spreadsheet and perform basic formulas like adding or multiplying.
  • You should be able to manage Outlook emails and schedule and attend meetings.
• Ability to communicate effectively and professionally both verbally and written.
• Ability to coordinate, analyze, observe, make decisions, and meet deadlines.
• May be required to perform other duties as assigned by Leadership Team Member.

Benefits

• Quality of life with a remote predictable, full‑time scheduleCompetitive hourly rate commensurate to experienceMedical, Dental, Vision coverage and moreLong‑term disability insurance, and life insuranceAmple parental leave401K with company matchCertification and Tuition ReimbursementHolidays, paid time off

Physical Demands

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye‑hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6‑8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.

Keywords: CPC, COC, CCS, CCS‑P, ProFee, Profession Fee, Hospital Outpatent, Facility, Denials, Coding, ICD‑10, CPT, HCPCS, EPIC

A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.