Remote PB Denials & Coding Integrity Specialist

Aurora Health Care; Allenton (WI); On-site; USD 70,000 - 100,000; Full time

Job summary

Aurora Health Care in Wisconsin is seeking a denial-management coder with strong background in CPT, HCPCS, and ICD-10-CM. You will analyze complex denials, identify patterns, and work with billing and payer teams to correct and appeal claims.

A4-year track record in professional or hospital coding and AHIMA/AAPC credentials are preferred. You will contribute to denial avoidance strategies, training initiatives, and revenue integrity projects, while maintaining compliance with official guidelines

Qualifications

• Associate degree or equivalent education and experience required.
• 4 years of expert-level professional coding or hospital-based coding experience aiding revenue cycle processes.
• Certification from AHIMA or AAPC preferred with relevant experience.

Responsibilities

• Analyze and resolve coding-related PB denials using CPT, HCPCS, ICD-10-CM, and modifiers.
• Identify root causes, patterns, and trends in denial and rejection 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, coding standards, and coverage policies.
• Ensure accurate, compliant coding and sequencing aligned with official guidelines and payer requirements.
• Track, document, and report denial resolutions, appeal outcomes, and coding quality issues.
• Support compliance, quality assurance, and revenue integrity initiatives through issue monitoring and escalation resolution.
• Educate clinicians, coders, and staff by sharing findings and supporting targeted training based on denial trends.
• Contribute to operational and strategic initiatives, including denial avoidance strategies, work queue optimization, CARC code mapping, and technology-driven improvements.

Skills

Denial analysis

Coding guidelines

CPT

HCPCS

ICD-10-CM/PCS

Payer collaboration

Data analysis

EHR systems

Education

Associate degree or equivalent education and experience

Tools

Microsoft Office

EHR systems

Job description

Aurora Health Care in Wisconsin is seeking a denial-management coder with strong background in CPT, HCPCS, and ICD-10-CM. You will analyze complex denials, identify patterns, and work with billing and payer teams to correct and appeal claims.

A4-year track record in professional or hospital coding and AHIMA/AAPC credentials are preferred. You will contribute to denial avoidance strategies, training initiatives, and revenue integrity projects, while maintaining compliance with official guidelines