About Us
Atlanta Neuroscience Institute (ANI) is a leading multidisciplinary neuroscience practice dedicated to providing exceptional patient care through innovative treatments, advanced diagnostics, and compassionate service. We are seeking a detail-oriented and experienced Medical Coding and Denial Management Specialist to join our growing team and help ensure accurate reimbursement and compliance with healthcare regulations.
Position Summary
The Medical Coding and Denial Management Specialist is responsible for ensuring accurate medical coding, timely claim submission, and effective resolution of insurance claim denials. This position plays a critical role in optimizing reimbursement, maintaining regulatory compliance, and improving the overall revenue cycle process. The ideal candidate possesses strong expertise in ICD-10, CPT, and HCPCS coding, payer guidelines, denial analysis, and appeals management.
Essential Duties and ResponsibilitiesMedical Coding
- Review provider documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes.
- Ensure coding compliance with CMS, Medicare, Medicaid, commercial payer, and specialty-specific guidelines.
- Identify documentation deficiencies and work with providers to obtain necessary clarification.
- Conduct coding audits and recommend corrective actions when needed.
- Stay current on coding changes, payer policies, and industry regulations.
Denial Management
- Analyze and investigate denied, rejected, and underpaid claims.
- Identify root causes of denials and implement corrective actions to prevent recurrence.
- Prepare and submit appeals, reconsiderations, and corrected claims within required timeframes.
- Monitor denial trends and provide recommendations to improve reimbursement outcomes.
- Collaborate with billing, coding, and clinical staff to resolve claim issues efficiently.
Revenue Cycle Support
- Verify claim accuracy prior to submission.
- Monitor accounts receivable and follow up on outstanding balances.
- Assist in reducing days in accounts receivable and improving collection rates.
- Generate reports on coding accuracy, denial rates, appeals success, and reimbursement performance.
- Support revenue cycle initiatives aimed at maximizing revenue and minimizing claim denials.
Compliance and Quality Assurance
- Maintain compliance with HIPAA and patient confidentiality requirements.
- Adhere to all federal, state, and payer regulations.
- Participate in internal audits and quality improvement activities.
- Maintain accurate records of denial resolutions and coding corrections.
Required Qualifications
- High school diploma or equivalent required.
- Minimum of 3 years of medical coding and denial management experience.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Experience with Medicare, Medicaid, and commercial insurance claims.
- Proficiency with electronic health records (EHR) and practice management software.
- Knowledge of payer-specific denial and appeal processes.
- Strong analytical, organizational, and problem-solving skills.
- Excellent written and verbal communication abilities.
Preferred Qualifications
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Outpatient Coder (COC), or equivalent certification.
- Experience in neurology and AthenaHealth EMR.
- Familiarity with revenue cycle management metrics and reporting.
- Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, or related field.
Pay: From $24.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Experience:
- EMR systems: 3 years (Required)
- Billing : 3 years (Required)
Work Location: Hybrid remote in Atlanta, GA 30327
