Remote Orthopedic Coding Denials Auditor

EnableComp LLC; Franklin (TN); On-site; USD 65,000 - 90,000; Full time

Job summary

EnableComp LLC seeks a Coding Denials Auditor to analyze coded medical services, review claims, and determine coding appropriateness for outpatient and professional claims. You will communicate findings internally and externally, supporting denial analysis and appeals.

The role requires orthopedic billing expertise, strong writing ability, and familiarity with CAC/Encoder audits, with remote work options possible depending on client needs.

Qualifications

• Associates or Bachelor's Degree required.
• Current CPC/CCA/CCS/RHIT certification preferred.
• 5+ years orthopedic surgery billing and coding experience.
• Strong written communication and ability to draft payor appeals.

Responsibilities

• Audit submitted claims for procedure and diagnosis code appropriateness.
• Review billing for accuracy and compliance with coding procedures.
• Collaborate with revenue cycle teams to resolve denials.
• Prepare correspondence and reports using Excel and related tools.
• Stay updated on medical coding guidelines and payer rules.
• Draft appeals to payors using CPT, guideline sources and articles.

Skills

Orthopedics billing

Surgical coding

Analytical skills

Communication skills

Time management

Education

Associates or Bachelor's Degree

Tools

Microsoft Office

CAC/Encoder audits

Job description

EnableComp LLC seeks a Coding Denials Auditor to analyze coded medical services, review claims, and determine coding appropriateness for outpatient and professional claims. You will communicate findings internally and externally, supporting denial analysis and appeals.

The role requires orthopedic billing expertise, strong writing ability, and familiarity with CAC/Encoder audits, with remote work options possible depending on client needs.