Senior Coding Denials & Appeals Specialist

The Medical College of Wisconsin, Inc.; Madison (WI); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Vision and dental coverage

401(k) plan

Job summary

The Coding Denials Specialist at The Medical College of Wisconsin, Inc. will handle advanced denials management, reviewing claims and supporting documentation to determine if revised submissions or appeals are required.

The role emphasizes accurate coding, documentation review, and timely payer communications to minimize denials. Applicants should bring strong CPT/ICD-10 knowledge, proficiency with EPIC and Office tools, and the ability to analyze trends for process improvements within a

Qualifications

• Knowledge of payer policies and claims requirements.
• Advanced knowledge of CPT, ICD-10 coding, payer and governmental policies.
• Proficiency with EMR’s (EPIC) and Microsoft Office.

Responsibilities

• Research payer denials related to coding, documentation, and billing.
• Review denials and supporting documents to determine necessary actions (re-submission, retro-authorization, appeals).
• Write and submit professional appeals with supporting policy language.
• Collaborate with prior authorization to obtain retro-auths as needed.
• Identify denial patterns and recommend process improvements.
• Escalate issues with appropriate stakeholders as needed.
• Perform other duties as assigned.

Skills

Payer policies

CPT coding

ICD-10 coding

EPIC EMR

Microsoft Office

Communication

Writing skills

Education

High school diploma

CCS-P or CPC or CCA

RHIT or RHIA

Bachelor’s in related field (preferred)

Tools

EPIC

Microsoft Office

Job description

The Coding Denials Specialist at The Medical College of Wisconsin, Inc. will handle advanced denials management, reviewing claims and supporting documentation to determine if revised submissions or appeals are required.

The role emphasizes accurate coding, documentation review, and timely payer communications to minimize denials. Applicants should bring strong CPT/ICD-10 knowledge, proficiency with EPIC and Office tools, and the ability to analyze trends for process improvements within a