Remote Coding Denials Resolution Specialist

Healthrise; United States; Remote; USD 70,000 - 95,000; Full time

Job summary

Healthrise seeks a Coding Denials Resolution Specialist to review post-billed denials for coding accuracy and to appeal them based on coding expertise. You will identify root causes and track appeals through multiple levels, ensuring timely filing and adherence to payer requirements.

The role emphasizes promoting coding best practices within revenue operations. Required are a coding certificate program and hospital/clinic experience; RHIA/RHIT/CCS/CPC credentials are preferred.

Qualifications

• Healthcare coding credentials required (RHIA/RHIT/CCS/CPC; CPMA considered).
• 4+ years in hospital/clinic healthcare financial services; experience in claims processing or related roles.

Responsibilities

• Review post-billed denials for coding accuracy and appeals.
• Identify root causes of denials and contribute to process improvements.
• Track appeals through first, second, and subsequent levels with timely filing.
• Promote departmental awareness of coding best practices.

Skills

ICD-10-CM/ICD-10-PCS/CPT-4 coding

Medical claims processing

DRG assignment

NCCI/NCD/LCD knowledge

Remote collaboration

Education

High school diploma or Associate degree in Accounting or related field

Coding certificate program

RHIA/RHIT/CCS/CPC/CPMA credentials

Tools

Job description

Healthrise seeks a Coding Denials Resolution Specialist to review post-billed denials for coding accuracy and to appeal them based on coding expertise. You will identify root causes and track appeals through multiple levels, ensuring timely filing and adherence to payer requirements.

The role emphasizes promoting coding best practices within revenue operations. Required are a coding certificate program and hospital/clinic experience; RHIA/RHIT/CCS/CPC credentials are preferred.