Denials Coder

CommonSpirit Health • Omaha, NE

2d

About The Position

The Denials Coder addresses and resolves outstanding insurance balances and complex coding denials as part of the revenue cycle. The role researches denial reasons, reviews medical records, and prepares supported written appeals to commercial and government health insurance payers to help ensure accurate reimbursement and minimize revenue leakage.

The position uses ICD-10 and CPT coding knowledge to compare documentation with billed services and make necessary adjustments to diagnosis codes, modifiers, and place-of-service information. The Denials Coder manages active work queues, collaborates with providers to correct claim errors, and serves as a point of contact for payer representatives. Duties also include electronically resubmitting claims and identifying recurring denial trends for proactive staff training, while maintaining compliant and efficient billing processes.

Requirements

• At least one year of coding experience.
• A strong foundation in medical insurance and reimbursement methodologies.
• Knowledge of ICD-10 and CPT coding.
• Detail orientation and critical-thinking skills, including the ability to troubleshoot complex billing issues.
• Clear, professional communication skills.
• Comfort working with automated coding and billing systems.
• Ability to prioritize tasks under pressure.
• Commitment to data integrity and regulatory compliance.

Nice To Haves

• High school graduate or GED and at least one year of coding experience upon hire (preferred).
• Associate degree in a related field and insurance follow-up experience upon hire (preferred).
• Completion of college-level courses in medical terminology, anatomy and physiology, disease processes, and pharmacology upon hire (preferred).
• Completion of an ICD-10 or CPT coding course upon hire (preferred).
• One of the following upon hire: Certified Professional Coder, Certified Coding Associate, Cardiology Coding, Certified Coding Specialist, or Registered Health Information Technician.

Responsibilities

• Research denial reasons and resolve outstanding insurance balances and complex coding denials.
• Review medical records and prepare supported written appeals to commercial and government health insurance payers.
• Compare documentation with billed services and adjust diagnosis codes, modifiers, and place-of-service information as needed.
• Manage active work queues and collaborate with providers to correct claim errors.
• Communicate with payer representatives.
• Resubmit claims electronically.
• Identify recurring denial trends and conduct proactive staff training.
• Support accurate reimbursement, minimize revenue leakage, and maintain compliant and efficient billing processes.

What This Job Offers

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