Revenue Cycle Coder Denial Specialist

Proliance Surgeons•Seattle, WA

4d•Hybrid

About The Position

At Proliance Surgeons our patients come from all walks of life — and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered. We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at www.proliancesurgeons.com/careers. Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity. Be Part of Who We Are! Position Summary 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
Work 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.