Revenue Cycle Coder Denial Specialist
Proliance Surgeons•Seattle, WA
•Hybrid
About The Position
We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist to join our team. This role plays a key part in identifying denial trends, supporting Accounts Receivable (AR) workflows, and driving resolution through research, coding review, and appeal preparation. The ideal candidate brings strong coding expertise, sharp critical thinking skills, and a solid understanding of the full-billing and reimbursement lifecycle. This position also serves as a coding float, providing flexible support and coverage across coding teams as needed.
Requirements
- Minimum 3 years of coding/medical billing experience
- Active certification with credentialing from AHIMA and/or AAPC, must be maintained annually
- ICD10 certified and/or extensive work experience
- Strong understanding of medical terminology, anatomy, and physiology
- Experience with denial management, AR workflows, and appeals
- A strong understanding of physiology, medical terms, and anatomy
- Thorough attention to detail
- Excellent written and verbal communication skills
- Self-motivated team player able to multi-task and prioritize
- Excellent organization and interpersonal communication skills
- Strong computer skills
- Strong computer skills/experience with Microsoft Excel, Outlook, and Adobe
- Working experience navigating EHR’s to abstract documentation
Nice To Haves
- Orthopedic coding experience strongly preferred
- Experience with NextGen and SIS systems preferred
Responsibilities
- Review and analyze denied claims to determine root cause and appropriate resolution
- Identify denial trends and collaborate with coding, billing, and AR teams to improve outcomes
- Prepare and submit detailed, compliant appeal letters with supporting documentation
- Perform coding reviews to ensure accuracy and alignment with payer guidelines, CPT, ICD-10-CM, and HCPCS standards
- Partner with AR team members to resolve complex accounts and reduce aging receivables
- Communicate with providers and staff to obtain necessary documentation or clarification
- Assist with education and feedback to coding and billing staff based on denial findings
- Maintain up-to-date knowledge of payer policies, regulatory requirements, and coding updates
- Provide coding support across specialties as needed in a float capacity
- Participate in process improvement initiatives to enhance revenue cycle performance
- Demonstrates appropriate utilization of coding software and coding reference material
- Follow up with providers on any documentation that is insufficient, missing, or unclear
- Assists providers with questions regarding coding and documentation guidelines
- Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders
- Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
