Remote Denial Recovery & Coding Analyst

UF Health; Gainesville (FL); Remote; USD 60,000 - 80,000; Full time

Job summary

UF Health seeks a Remote Denial Management Specialist to optimize reimbursement and reduce denials across the enterprise. You will oversee clinical denial queues, coordinating with Managed Care and payers, and lead coding accuracy initiatives.

Ideal candidates have 1–2 years of coding and denial management experience, plus relevant certifications (CPC/COC/RHIT/RHIA/CCS). This full-time role emphasizes regulatory compliance and performance metrics.

Qualifications

• 1–2 years of coding experience required.
• 1–2 years of denial management/insurance experience required.
• CPC, COC, RHIT, RHIA, or CCS certification required for the role.

Responsibilities

• Manage clinical denials from denial work queues: resubmission, verifications, reprocessing, reconsiderations, and appeals.
• Collaborate with Managed Care and payers to reduce denials and boost reimbursement.
• Recommend coding/documentation improvements based on denial analysis and guidelines.
• Meet productivity: 30 worked accounts in 8 hours with 98% accuracy from denial queues.
• Use coding software, NCCI, ICD-10, CPT, HCPCS, and CMS guidelines to review and correct accounts.
• Partner with managers to report, track, and resolve denials; assist audits and root-cause analysis.
• Handle multiple payer work queues including Medicare, Medicaid, government and commercial payers, and Medicare Advantage.
• Research denials related to authorization, medical necessity, non-covered services, coding and billing; initiate timely appeals.
• Submit customized reconsiderations and appeals based on chart review and policies.
• Identify denial patterns and escalate findings with sufficient info for follow-up.
• Review payer communications to assess reimbursement risks from policies and prior authorizations.
• Review coding, apply modifiers, correct diagnosis sequencing, and adjust codes to resolve denials.
• Review and adjust charges per charging and billing guidelines.
• Educate staff to reduce denials and errors; cooperate on process improvements.
• Analyze denied claims to identify root causes and reimbursement issues.

Skills

Coding experience

Denial management

Insurance knowledge

Education

High School Diploma or GED

CPC

COC

RHIT

RHIA

CCS

Job description

UF Health seeks a Remote Denial Management Specialist to optimize reimbursement and reduce denials across the enterprise. You will oversee clinical denial queues, coordinating with Managed Care and payers, and lead coding accuracy initiatives.

Ideal candidates have 1–2 years of coding and denial management experience, plus relevant certifications (CPC/COC/RHIT/RHIA/CCS). This full-time role emphasizes regulatory compliance and performance metrics.