Denials Coder
About The Position
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. To be successful in this role, you will bring at least one year of coding experience and a strong foundation in medical insurance and reimbursement methodologies. We are looking for a detail-oriented professional who excels at critical thinking, possesses the ability to troubleshoot complex billing issues, and demonstrates clear, professional communication skills. You should be comfortable working with automated coding and billing systems, capable of prioritizing tasks under pressure, and committed to upholding the highest standards of data integrity and regulatory compliance.
Requirements
- At least one year of coding experience.
- Strong foundation in medical insurance and reimbursement methodologies.
- Detail-oriented.
- 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.
Nice To Haves
- High School Graduate General Studies and 1+ years coding experience, upon hire
- Associates Other in related field and Insurance follow up experience, upon hire
- Completion of college level courses in medical terminology, anatomy and physiology, disease processes and pharmacology., upon hire
- Certified Professional Coder, upon hire
- Certified Professional Coder Hospital Apprentice, upon hire
- Registered Health Information Technician, upon hire
Responsibilities
- Addressing and resolving outstanding insurance balances and complex coding denials.
- Researching denial reasons.
- Reviewing medical records.
- Submitting appeals to commercial and government health insurance payers.
- Comparing documentation against billed services.
- Making necessary adjustments to diagnosis codes, modifiers, and place-of-service information.
- Managing active work queues.
- Collaborating with providers to rectify claim errors.
- Serving as a key point of contact for payer representatives.
- Resubmitting claims electronically.
- Identifying recurring denial trends to conduct proactive staff training.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
