Top 449 claims denials Jobs in remote

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5d

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claims denials jobs near remote

Coding Specialist- holds and denials CPC

Caduceus Health -
Remote

Quick Apply

Job Details

Full-time
$25 - $27 an hour

Benefits

Continuing education credits
Health insurance
Dental insurance
Paid time off
Vision insurance

Qualifications

Medical coding
Research
Certified Professional Coder

Full Job Description

Position overview:

The Coding Specialist is responsible for independently reviewing, analyzing, and resolving all assigned front-end claims to ensure accurate and timely claim submission. This position focuses on identifying and correcting coding-related issues prior to claim transmission, applying established coding guidelines, payer requirements, and organizational policies. The Coding Specialist I works closely with revenue cycle partners to prevent claim rejections, support clean claim rates, and promote efficient reimbursement processes. This role requires strong attention to detail, foundational coding knowledge, and the ability to work independently in a fast-paced environment.

Averages 10 front-end holds per hour
Maintains a minimum of 90% coding accuracy.
Assigns ICD-10-CM and CPT codes with appropriate modifiers for services provided in the professional fee environment.
Reviews medical records and all applicable documentation to determine appropriate codes for documented services and diagnoses.
Ensures all diagnosis codes meet local and national medical necessity guidelines.
Utilizes internal coding resources, payer guidelines, and other reference materials to ensure accurate and compliant coding for all assigned services.
Follows all HIPAA regulations and upholds the highest standards of privacy and confidentiality.
Maintains current knowledge of laws, regulations, payer policies, and industry guidance impacting compliant coding practices.
Independently reviews and resolves all assigned front-end claim holds.
Actively participates in department meetings, one-on-one meetings, and mentorship meetings with the assigned Coding Team Lead.
Escalates identified client trends to the assigned Coding Team Lead.
Escalates all coding-related questions to the assigned Coding Team Lead for guidance and clarification.
Maintains and completes all CEU requirements.
Performs other duties or tasks as assigned.
Must hold a current AAPC or AHIMA Certification for a minimum of 3 years.
Strong working knowledge of CPT, ICD-10-CM, medical terminology, anatomy and physiology, and state and federal Medicare reimbursement guidelines.
Familiarity with proper English grammar, usage, and professional documentation standards.
Ability to research and analyze data, draw logical conclusions, and resolve coding or documentation issues.
Ability to read, interpret, and apply policies, procedures, laws, and regulations.
Ability to accurately read and interpret medical documentation, clinical terminology, and documented procedures.
Demonstrated ability to exercise independent judgment in coding and claim resolution.
Excellent written and verbal communication skills, including the ability to prepare reports, clarify documentation needs, and maintain collaborative working relationships with physicians and staff.
Strong commitment to maintaining confidentiality and safeguarding protected health information.
Prior experience working in a medical billing environment with strict adherence to HIPAA compliance requirements.
Demonstrated proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).
Minimum of 3+ years of professional coding experience.
Standard business office environment with moderate noise levels.
Requires extended periods of computer and monitor use.
Ability to lift and move up to 30 pounds on a non-routine basis.
Ability to sit for extended periods while performing coding and claim review tasks.
Frequent handling, including seizing, holding, grasping, and fingering objects, tools, and controls.
Close vision required to read medical documentation, electronic health records, and coding resources.
Hearing ability sufficient to receive and interpret detailed information through oral and telephonic communication.

Job Type: Full-time

Pay: $25.00 - $27.00 per hour

Benefits:

Dental insurance
Health insurance
Paid time off
Vision insurance

Experience:

Medical coding: 5 years (Required)

License/Certification:

Certified Professional Coder (Required)

Work Location: Remote

Quick Apply

Refine Your Search

claims denials jobs in remote

Coding Specialist- holds and denials CPC

Coding Appeals Specialist

Denials Specialist

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Patient Account Rep I

Denials Representative

Denials and Appeals Representative

Insurance Claims Specialist HB

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Revenue Cycle Specialist

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Medical Billing Specialist – Pediatric Therapy

Professional Billing Specialist

Provider Enrollment Denials Representative

Remote Insurance Follow-Up Representative- Hospice

Medicaid Account Resolution Specialist - Digitech - Remote

Credit Balance Specialist

I want to receive the latest job alert for claims denials in remote

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