Medical College of Wisconsin - Staff
Coding Denials Specialist
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Job Description
- Req#: 35220
Employer Industry: Healthcare Services
Why consider this job opportunity:
- 100% remote work opportunity available in select states: WI, FL, MN, NC, TN, & TX
- Competitive salary with opportunities for bonuses based on performance
- Chance to make a significant impact on reducing coding denials and improving revenue cycles
- Supportive work environment focused on continuous process improvement
- Opportunity for career advancement within a dynamic healthcare organization
What to Expect (Job Responsibilities):
- Research payer denials related to coding, documentation, and billing to resolve claims issues
- Conduct comprehensive reviews of denial cases and determine necessary actions
- Write and submit professional appeals with compelling arguments based on clinical documentation
- Collaborate with the prior authorization team to address authorization denials
- Identify denial patterns and recommend process improvements to management
What is Required (Qualifications):
- Advanced knowledge of CPT, ICD-10 coding, and payer policies
- Proficiency with Electronic Medical Records (EMR) systems, specifically EPIC
- Strong written and verbal communication skills
- Ability to manage multiple tasks efficiently in a fast-paced environment
- Demonstrated effective interpersonal skills and problem-solving abilities
How to Stand Out (Preferred Qualifications):
- Experience in coding denials management within a healthcare setting
- Familiarity with Medicare, Medicaid, and third-party payer guidelines
- Previous involvement in process improvement initiatives
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