Revenue Integrity Denials Expert

Hartford HealthCare; Farmington (CT); On-site; USD 55,000 - 85,000; Full time

Job summary

Hartford HealthCare is seeking a Revenue Integrity Denials Specialist to review and resolve coding denials and patient account issues. You will research denials, verify documentation, and ensure accurate ICD-10-CM and CPT/HCPCS coding within Epic.

The role requires CPC/CCS-P certification and 3–5 years in denial management or healthcare experience, with strong communication and time-management skills.

Qualifications

• Associate’s degree or equivalent work experience.
• 3-5 years of experience with professional Coding denial/avoidable write-off (or healthcare experience).
• CPC, CCS-P certification required and maintained thereafter.
• Strong written and verbal communication skills.
• Strong knowledge of coding concepts.
• ICD-10-CM diagnostic and CPT/HCPCS procedure codes & modifiers.
• Clinical information related to areas of responsibility.
• Knowledge of insurance claim processing and EOB/remittance codes.

Responsibilities

• Review and research coding denials and customer service complaints to bring to resolution.
• Review medical records for reconsideration purposes.
• Assign appropriate ICD-10-CM, CPT/HCPCS codes, modifiers and E/M codes as required.
• Document all account activity in Epic.
• Meet revenue cycle KPIs and productivity standards.
• Assist manager with training new colleagues.

Skills

Coding concepts

Medical necessity understanding

Problem-solving

Time management

Communication

Education

Associate’s degree or equivalent work experience

Tools

Encoder

Excel

Job description

Hartford HealthCare is seeking a Revenue Integrity Denials Specialist to review and resolve coding denials and patient account issues. You will research denials, verify documentation, and ensure accurate ICD-10-CM and CPT/HCPCS coding within Epic.

The role requires CPC/CCS-P certification and 3–5 years in denial management or healthcare experience, with strong communication and time-management skills.