Position Summary
We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist (Remote) to join our team. This role plays a key part in identifying denial trends, supporting Accounts Receivable (AR) workflows, and driving resolution through research, coding review, and appeal preparation.
The ideal candidate brings strong coding expertise, sharp critical thinking skills, and a solid understanding of the full-billing and reimbursement lifecycle. This position also serves as a coding float, providing flexible support and coverage across coding teams as needed. Must have an active CPC certification with credentialing from AHIMA and/or AAPC.
Schedule
Full-time, Monday - Friday.
**Must live in one of the following states or be willing to relocate to: WA, ID, FL, NC, AZ, OH, OR, TN, TX, or RI.**
Key Duties and Responsibilities
The key duties and responsibilities of the Revenue Cycle Coder include, but are not limited to:
Review and analyze denied claims to determine root cause and appropriate resolution
Identify denial trends and collaborate with coding, billing, and AR teams to improve outcomes
Prepare and submit detailed, compliant appeal letters with supporting documentation
Perform coding reviews to ensure accuracy and alignment with payer guidelines, CPT, ICD-10-CM, and HCPCS standards
Partner with AR team members to resolve complex accounts and reduce aging receivables
Communicate with providers and staff to obtain necessary documentation or clarification
Assist with education and feedback to coding and billing staff based on denial findings
Maintain up-to-date knowledge of payer policies, regulatory requirements, and coding updates
Provide coding support across specialties as needed in a float capacity
Participate in process improvement initiatives to enhance revenue cycle performance.
Demonstrates appropriate utilization of coding software and coding reference material.
Follow up with providers on any documentation that is insufficient, missing, or unclear.
Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders.
Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines.
Education/Experience
Minimum 3 years of coding/medical billing experience
Active CPC certification with credentialing from AHIMA and/or AAPC, must be maintained annually --- required
ICD10 certified and/or extensive work experience
Strong understanding of medical terminology, anatomy, and physiology
Experience with denial management, AR workflows, and appeals
Orthopedic coding experience strongly preferred
Experience with NextGen and SIS systems preferred
Knowledge, Skills and Abilities
A strong understanding of physiology, medical terms, and anatomy
Thorough attention to detail
Excellent written and verbal communication skills
Self-motivated team player able to multi-task and prioritize
Excellent organization and interpersonal communication skills
Strong computer skills
Strong computer skills/experience with Microsoft Excel, Outlook, and Adobe
Working experience navigating EHR’s to abstract documentation
Work Environment/Physical Demands
The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.
Work may be performed in a remote office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.