Analyst Coding | Enterprise Denial Management | Full Time | Day Shift
About The Position
Serves as an enterprise-level dynamic denial management coding analyst focused on reducing denials, improving reimbursement, and maintaining high coding standards. Analyzes denial trends, Epic system edits, coding and CDM processes, authorization performance, and payer behaviors to drive improvements. Leads initiatives to enhance coding effectiveness and appeal turnaround times, while educating departments on compliant charging, billing, and coding practices. Collaborates with Managed Care and Compliance to resolve reimbursement and payer-related issues.
Requirements
- High School Diploma or GED
- At least one of the following coding certifications is required: CPC, COC, CCS, CCS-P, CCA, CIC, RHIA, RHIT
- 1–2 years of coding experience
- 1–2 years of denial management and insurance experience
- Demonstrated knowledge of:
- Hospital billing and reimbursement
- Medicare and Medicaid denials and appeals
- Third-party payer contracts
- Federal and state healthcare regulations
- Strong critical thinking and analytical skills
- High attention to detail with the ability to work independently and minimize errors
- Proficient organizational and time-management skills
- Excellent written and verbal communication skills
- Proficiency in Microsoft Office applications (Outlook, Word, Excel)
- Knowledge of HIPAA guidelines
- Ability to read and interpret Explanation of Benefits (EOBs)
- Strong research and problem-solving skills
- High level of comfort working with computer systems
Nice To Haves
- Experience in coding, medical record review, auditing, and insurance processes
Responsibilities
- Serves as the enterprise-level dynamic denial management coding analyst, supporting low denial rates and optimal reimbursement.
- Maintains high coding standards across the organization to ensure accuracy and compliance.
- Organizes, plans, and leads projects aimed at improving dynamic coding effectiveness, reimbursement performance, and appeal turnaround times.
- Performs detailed denial trend analyses, including:
- Epic system edits
- Coding validation
- Charge Description Master (CDM) processes impacting reimbursement
- Authorization trends and performance improvement
- Payer-specific denial trends
- Educates departments on appropriate charging, billing, and coding practices to ensure regulatory compliance.
- Collaborates with Managed Care and Compliance teams to resolve coding, billing, and reimbursement issues with internal departments and external payers.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
