PB & HB Coding Edits & Denials Specialist (AAPC or AHIMA Cert. Req.d)

CorroHealth•TX-Remote, TX

4d•Remote

About The Position

CorroHealth is seeking a certified ProFee coder to support long-term client partnerships through coding excellence. This remote, autonomous role combines hands-on denial resolution, payer policy research, coding review, and revenue integrity support. The specialist works with ProFee and hospital outpatient/facility denials and is expected to meet ongoing productivity and quality standards, including an accuracy rate of 95% or higher. The position requires permanent U.S. work authorization and residence and work within the continental United States. Candidates must complete a proctored ProFee Coding assessment. The role requires the ability to work independently from home, regular and punctual attendance, and compliance with coding ethics, company policies, privacy and security rules, and protection of confidential information.

Requirements

AAPC CPC or COC certification, or AHIMA CCS or CCS-P certification; coders must maintain at least one AAPC or AHIMA credential.
At least six months of on-the-job experience.
Strong experience in ProFee and hospital outpatient/facility denials.
Understanding of Remit and CARC codes.
Working knowledge and experience with systems such as EMR and billing systems.
Ability to work independently from home and demonstrate independent coding skills.
Regular, predictable, and punctual attendance.
Phone, reliable internet connection, and current coding materials, including CPT and ICD-10-CM references.
Proficiency with Microsoft programs such as Excel and Outlook, including basic spreadsheet formulas and managing email, meetings, and schedules.
Effective and professional verbal and written communication skills.
Ability to coordinate, analyze, observe, make decisions, and meet deadlines.
Permanent U.S. work status (U.S. citizen or Green Card holder) and residence and work within the continental United States.
Completion of a proctored ProFee Coding assessment as part of the application process.

Responsibilities

Provide coding services to support clients.
Review and resolve denials in EPIC.
Research payer policies and identify trending denial issues for escalation to management.
Resolve Medical Necessity and CCI edits.
Code surgical procedures typical of an emergency room setting to capture additional revenue when appropriate.
Apply ICD-10-CM diagnosis codes to the highest level of specificity available and accurately apply ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS codes.
Interpret coding guidelines for accurate code assignment.
Assess the importance of documentation in code assignment and its reimbursement impact.
Align conduct with AHIMA's Standards of Ethical Coding, the Company's Code of Ethics and Business Conduct, and the Company's Ethics and Compliance Program.
Comply with internal policies and procedures and participate in company-provided training and education.
Maintain at least one AAPC or AHIMA credential.
Comply with privacy and security rules and protect company confidential information, including Personal Health Information.
Maintain required productivity and an accuracy rate of at least 95%.
Perform other duties as assigned by leadership.