Denials Coder

CommonSpirit Health • Omaha, NE

5d

About The Position

Where You’ll Work From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy. We offer more than 20 specialties and 100 convenient locations; with some clinics offering extended hours. As our Denials Coder you will play a critical role in our revenue cycle by addressing and resolving outstanding insurance balances and complex coding denials. You will leverage your analytical expertise to research denial reasons, review medical records, and submit well-written, supported appeals to both commercial and government health insurance payers. By ensuring accurate reimbursement and minimizing revenue leakage, you will directly contribute to the financial health and operational success of the Alegent Creighton Clinic. Every day you will utilize your deep knowledge of ICD-10 and CPT coding to compare documentation against billed services, making necessary adjustments to diagnosis codes, modifiers, and place-of-service information. You will manage active work queues, collaborate with providers to rectify claim errors, and serve as a key point of contact for payer representatives. Whether resubmitting claims electronically or identifying recurring denial trends to conduct proactive staff training, your work will ensure that our billing processes remain compliant and efficient.

Requirements

• At least one year of coding experience.
• Strong foundation in medical insurance and reimbursement methodologies.
• Detail-oriented professional.
• Excels at critical thinking.
• Ability to troubleshoot complex billing issues.
• Clear, professional communication skills.
• Comfortable working with automated coding and billing systems.
• Capable of prioritizing tasks under pressure.
• Committed to upholding the highest standards of data integrity and regulatory compliance.
• High School Graduate General Studies, upon hire
• Completion of college level courses in medical terminology, anatomy and physiology, disease processes and pharmacology., upon hire

Nice To Haves

• 1+ years coding experience, upon hire
• Associates Other in related field and Insurance follow up experience, upon hire
• Certified Professional Coder, upon hire
• Certified Professional Coder Hospital Apprentice, upon hire
• Registered Health Information Technician, upon hire

Responsibilities

• Address and resolve outstanding insurance balances and complex coding denials.
• Research denial reasons and review medical records.
• Submit well-written, supported appeals to both commercial and government health insurance payers.
• Compare documentation against billed services, making necessary adjustments to diagnosis codes, modifiers, and place-of-service information.
• Manage active work queues.
• Collaborate with providers to rectify claim errors.
• Serve as a key point of contact for payer representatives.
• Resubmit claims electronically.
• Identify recurring denial trends to conduct proactive staff training.

What This Job Offers

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