Coding Analyst Denials Appeals

Dignity Health Medical Group • Phoenix, AZ

3d • $24 - $36

About The Position

The Coding Analyst Denials Appeals reviews records for coding errors and corrects diagnostic and procedural codes in the billing system to support accurate reimbursement. The role analyzes complex data and uses ICD-10-CM, CPT, HCPCS, and modifiers to investigate, correct, and resubmit medical claims rejected or denied by insurance companies. It handles coding-related denials across multiple specialties and markets, submits corrected claims, reconsiderations, and appeals to health plans, and identifies and communicates payer or system trends to management. The position requires maintaining knowledge of payer contracts, regulations, guidelines, and applicable state and federal billing and collection laws to support accurate, compliant billing. The analyst communicates with coworkers, leadership, and outside organizations to help meet departmental goals and ensure timely reimbursement.

Requirements

• High school graduate.
• Three years of prior experience in medical coding and/or billing for physician office services.
• Proficiency assigning ICD-10-CM, CPT, HCPCS, and modifiers.
• Ability to read and comprehend an EOB.
• Proficiency in guidelines, CCI, LMRP, coding, and use of modifiers.
• Ability to research CPT and ICD-10 codes to bill appropriately.
• Proficiency in reimbursement matters, including benefit investigations, payer reimbursement policies, and regulatory and administrative rules.
• Knowledge of physician and insurance reimbursement and billing concepts and procedures, and laws and regulations affecting payment compliance, denials, and appeals recovery.
• Proficient understanding of medical coding systems affecting claims-payment adjudication.
• Proficiency using Google Workspace.
• Must hold at least one of the following certifications: CPC, CPCA, CCS, CCS-P, CCVTC, CHC, CIRCC, RCC, RHIA, or RHIT.

Nice To Haves

• Associate degree.
• Five years of work experience in medical billing and coding for physician office services.

Responsibilities

• Review medical records for coding errors and correct diagnostic and procedural codes in the billing system.
• Investigate, correct, and resubmit medical claims rejected or denied by insurance companies.
• Correct modifiers and ICD-10, CPT, or HCPCS codes in the practice management system when appropriate.
• Submit corrected claims, reconsiderations, and appeals to health plans.
• Analyze complex data and identify payer or system trends; communicate findings to management.
• Maintain knowledge of payer contracts, regulations, guidelines, and state and federal laws related to billing and collections.
• Communicate with coworkers, leadership, and outside organizations to meet departmental goals and support timely reimbursement.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED