Coding Denial Management Associate

athenahealth•Belfast, SC

1d•$50,000 - $86,000•Hybrid

About The Position

We are looking for a Coding Denials Management Associate to join the Denials Management team. In this role, the Coding Denials Management Associate will work to apply their coding skills to diagnose and resolve claim denials, rejections, and edits across our network. This individual will analyze denial trends, identify root causes, and develop workflow improvements to support the performance of our service offering. The Coding Denials Management Associate will partner closely with Product, Analytics, and Operational teams. This role reports to the Manager of Service Effectiveness – Denials Management.

Requirements

Bachelor’s degree or equivalent professional experience.
CPC and/or CCS certification (AAPC or AHIMA) is required.
3+ years in medical coding with demonstrated experience in claims adjudication, denials, or revenue cycle operations.

Nice To Haves

Revenue cycle experience working with denials, rules, payer edits, 835/ERA or EOB review, appeals/resubmissions, and claim reprocessing workflows.
Experience using SQL or Sigma to extract data and leverage analytical tools to generate insights and actionable recommendations.

Responsibilities

Lead detailed claim adjudication analysis to triage rejections, denials, and payer edits; convert adjudication scenarios into consumable, effective processes that identify true root causes and lead to successful outcomes.
Prepare accurate workflows and procedures: claim corrections, resubmissions, appeals, or configuration updates; partner multiple stakeholders to execute.
Track denial trends, quantify financial impact, and deliver actionable insights and dashboards to stakeholders.
Recommend and validate configuration or workflow changes (mapping, process design and workflow management) that prevent repeat denials.
Manage multiple remediation projects by urgency/financial impact, and present findings to partners and leadership.
Proficiency with project management and analytical tools; ability to operate in an agile environment.