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

CorroHealth, Inc.; United States; Remote; USD 34,000 - 55,000; Full time

Benefits offered by this job

Remote work

Full-time schedule

Medical, Dental, Vision coverage

401K with company match

Certification and Tuition Reimb

Holidays, paid time off

Job summary

CorroHealth, Inc. is seeking a certified ProFee coder to join its remote team.

You will handle denial resolution, payer policy research, coding review, and revenue integrity support for hospital outpatient/facility claims, emphasizing accuracy and efficiency in a fast-paced environment. The role requires CPC/COC or CCS/CCS-P certification, at least six months experience, proficiency in EPIC, CPT, ICD-10-CM/PCS, Excel and Outlook, and a commitment to privacy and ethics while supporting long-term

Qualifications

• 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‑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 abd 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.

Responsibilities

• Provide various components of coding services to support our clients.
• Strong experience in ProFee and Hospital Outpatient (Facility) denials.
• 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

Skills

ProFee coding

Hospital outpatient denials

CPT/HCPCS coding

Excel

Outlook

Effective communication

Education

AAPC CPC/COC or AHIMA CCS/CCS-P

Tools

EPIC

EMR

Job description

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.

• 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‑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 abd 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.

We Offer:

• Quality of life with a remote predictable, full-time schedule
• Competitive hourly rate commensurate to experience
• Medical, Dental, Vision coverage and more
• Long‑term disability insurance, and life insurance
• Ample parental leave
• 401K with company match
• Certification and Tuition Reimbursement
• Holidays, paid time off

Keywords:

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

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.

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.

CorroHealth sits at the center of the revenue cycle revolution. Fundamental operations of the revenue cycle are supported through our expert teams while we recast the role of clinicians through automation. This shift to a true clinical revenue cycle helps us achieve our core purpose – exceed client financial health goals. For each patient population, CorroHealth automates key clinical aspects of the cycle. Our platforms focus on capture and application of clinical documentation while easing the burden on physicians. Scalability is prioritized in the support of client program operations. As with most revenue cycle partners, our skilled and enthusiastic team is available to outsource any portion of the cycle. However, we can also complement client programs with additional expert support or upskill existing client teams to meet program demands. Whether our team is deployed directly, or automation is incorporated for a more programmatic solution, CorroHealth delivers. CorroHealth has acquired Xtend Healthcare! For more information, please visit https://corrohealth.com.

Applicants will only receive job-related emails from the domain @corrohealth.com. Additionally, it is important to emphasize that CorroHealth will never ask for money in return for a job offer.