Remote Inpatient Denials & Revenue Integrity Specialist

Aurora Health Care; Allenton (WI); On-site; USD 65,000 - 95,000; Full time

Job summary

Aurora Health Care is seeking a skilled denials and coding analyst to analyze and resolve PB/HB denials using CPT, HCPCS, ICD-10-CM, and modifiers. The role emphasizes collaboration across billing, coding, and payer teams to correct, resubmit, and prevent denied claims.

Applicants should have an Associate degree or equivalent, 4+ years of hospital coding and revenue cycle experience, and hold AHIMA or AAPC credentials. Strong knowledge of guidelines and issue tracking is required.

Qualifications

• Associate degree or equivalent education and experience required.
• Coding credential required (AHIMA or AAPC) with relevant experience.
• 4 years of expert-level hospital-based coding and revenue cycle experience.
• Advanced knowledge of CPT, HCPCS, ICD-10-CM/PCS, and official coding guidelines.

Responsibilities

• Analyze and resolve coding-related PB and HB denials using CPT, HCPCS, ICD-10-CM, and modifiers.
• Identify root causes and trends in denial codes.
• Collaborate with billing, coding, and payer teams to correct, resubmit, and prevent denied claims.
• Conduct chart reviews to validate documentation against billed services.
• Prepare and support appeals by researching payer guidelines and coverage policies.
• Ensure compliant coding and sequencing aligned with guidelines and payer requirements.
• Track and report denial resolutions, appeal outcomes, and coding quality issues.
• Support compliance, QA, and revenue integrity initiatives through monitoring and escalation.
• Educate clinicians, coders, and staff on denial trends and training.
• Contribute to denial avoidance strategies, work queue optimization, CARC code mapping, and tech-driven improvements.

Skills

Third-party reimbursement

Medical terminology

Coding discrepancies

Data analysis

EHR systems

Communication skills

Organizational skills

Education

Associate degree or equivalent education and experience

Tools

Microsoft Office

EHR systems

Job description

Aurora Health Care is seeking a skilled denials and coding analyst to analyze and resolve PB/HB denials using CPT, HCPCS, ICD-10-CM, and modifiers. The role emphasizes collaboration across billing, coding, and payer teams to correct, resubmit, and prevent denied claims.

Applicants should have an Associate degree or equivalent, 4+ years of hospital coding and revenue cycle experience, and hold AHIMA or AAPC credentials. Strong knowledge of guidelines and issue tracking is required.