Senior Medical Coding Auditor – Denials & Appeals

Baylor Scott & White Health; Denver (CO); On-site; USD 68,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401(k) match

Tuition Reimbursement

PTO from Day 1

Job summary

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review and appeal complex coding denials across Hospital and Professional Billing, ensuring documentation supports billed services and reported diagnoses.

The role requires advanced coding knowledge, CMS/payer policy understanding, and collaboration with RNs, coders, and revenue cycle teams to improve coding accuracy and reduce denials.

Qualifications

• Six or more years of coding, audits, denial management or revenue cycle experience.
• HS Diploma/GED required; degree preferred in HIM/Healthcare.
• Certified coding certification (CPC/CCS/RHIT/RHIA or equivalent) preferred or required.

Responsibilities

• Review and audit coding denials to determine resolution and appeal strategies.
• Investigate and appeal HB/PB denials including DRG downgrades and MUE denials.
• Apply ICD-10-CM, ICD-10-PCS, CPT/HCPCS coding knowledge to evaluate denied claims.
• Prepare clear, compliant appeal documentation with supporting references.
• Research and validate coding positions and communicate recommendations.

Skills

ICD-10 coding

DRG assignment

Payer policy knowledge

Epic experience

Education

Health Information Management degree

CPC/CCS/RHIT/RHIA certification

Tools

Excel

Payer portals

Job description

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review and appeal complex coding denials across Hospital and Professional Billing, ensuring documentation supports billed services and reported diagnoses.

The role requires advanced coding knowledge, CMS/payer policy understanding, and collaboration with RNs, coders, and revenue cycle teams to improve coding accuracy and reduce denials.