Coding Denials Specialist

JOB SUMMARY:

This position reports to the Revenue Integrity & Coding Supervisor under the direction of the Director of Revenue Cycle. Responsibilities include analyzing and investigating coding edits and denials within the billing scrubber. Proficient in writing appeals and collaborating with clinical departments and business office on denial patterns and opportunities. Strong understanding of coding guidelines, NCCI edits, CMS regulations, payer edits, and the ability to read and understand EOBs. Strong communication skills and able to critically think through processes. Ability to multi-task and float within the department and complete any duties as assigned.

Minimum knowledge, skills, and abilities:

• Associate or bachelor’s degree, preferred.


• Required certifications: RHIA, RHIT, or coding certification (CCS, CCS-P, CPC)




• In lieu of certification, require 3-5 years of coding and/or billing experience (Coding certification within 2 years of hire date).




• 1 plus years of experience in coding, professional, facility or both.


• Knowledge of ICD 10CM/PCS and CPT/HCPCS


• Strong understanding of reimbursement methodology, federal, state, and payer coding documentation and billing requirements, like CMS medical necessity


• Ability to multi-task and prioritize a workload in a fast-paced environment


• Strong written and oral communication skills


• Strong computer knowledge with ability to learn specific coding/billing systems. Proficient in Excel.


• Self-motivated with critical attention to detail and deadlines


• Ability to work independently, as well as in a strong team environment


• Must live in the state of Iowa