Coding Denials Specialist

Job Summary

A company is looking for a Coding Denials Specialist responsible for managing claim edits and resolving health plan denials.

Key Responsibilities

• Process accounts related to coding denial management, including rejections and bundling issues
• Resolve work queues according to priority and departmental guidelines
• Generate appeals based on denial reasons and payer guidelines

Required Qualifications

• High school diploma or equivalent
• One to three years of experience in physician medical billing, focusing on claim denials
• Knowledge of health insurance coding and physician billing policies
• Familiarity with healthcare reimbursement guidelines and coding standards
• Proficient in computer skills, including basic Excel knowledge