Remote Coding Denials & Appeals Specialist

Medical College of Wisconsin; Wauwatosa (WI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health coverage

Tuition Reimbursement

Paid Holidays

Parental Leave

EFAP

Job summary

The Coding Denials Specialist at Medical College of Wisconsin performs advanced coding denials management, resolving claim edits and denials while monitoring trends to minimize avoidable adjustments. The role requires expert CPT/ICD-10 knowledge, familiarity with EPIC, and strong written communication skills.

Responsibilities include researching payer denials, reviewing associated records, writing professional appeals, and coordinating with prior authorization teams to secure

Qualifications

• Minimum of a high school diploma; additional education preferred.
• Five years of experience in health care coding or reimbursement follow-up.

Responsibilities

• Research payer denials related to coding, documentation and pre-authorization.
• Review denials with medical records to decide if revised claims or appeals are needed.
• Write and submit detailed appeals based on documentation, policies and contracts.
• Collaborate with prior authorization to obtain retro-authorizations as required.
• Identify denial patterns and recommend improvements to reduce denials.

Skills

CPT coding

ICD-10 coding

payer policies

EMR EPIC

Microsoft Office

Education

High school diploma

Bachelor's degree preferred

Tools

EPIC

Microsoft Office

Job description

The Coding Denials Specialist at Medical College of Wisconsin performs advanced coding denials management, resolving claim edits and denials while monitoring trends to minimize avoidable adjustments. The role requires expert CPT/ICD-10 knowledge, familiarity with EPIC, and strong written communication skills.

Responsibilities include researching payer denials, reviewing associated records, writing professional appeals, and coordinating with prior authorization teams to secure