Pn Cert Prof Coding Denial Specialist

Cook Children's Health Care System

Remote, TX, US
Fully remote
Complex coding denials resolution
Coding-related claims edits
Payer communication and appeals
Cook Children's Health Care System is seeking a Certified Professional Coding Denial Specialist for a fully remote position. The role involves resolving complex coding denials and requires extensive coding experience and knowledge of medical coding standards

Job Summary

  • The Certified Professional Coding Denial Specialist is responsible for reviewing and determining the root cause of complex coding denials for all providers employed by Cook Children’s Physicians Network.
  • The specialist will analyze and perform appropriate actions for timely completion of special projects, utilizing their deep understanding of coding and classification software and the electronic health record (EHR) system.
  • Cook Children's is an equal opportunity employer offering equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class.

Matching Summary

Match Score: 85

Cook Children's Health Care System is seeking a Certified Professional Coding Denial Specialist for a fully remote position. The role involves resolving complex coding denials and requires extensive coding experience and knowledge of medical coding standards.

Skills & Requirements

Must-have

  • Complex coding denials resolution
  • Coding-related claims edits
  • Payer communication and appeals
  • Use of CMS, AMA, AAPC guidelines
  • Electronic health record system
  • Microsoft Excel proficiency

Nice-to-have

  • Professional interpersonal skills
  • Effective communication skills
  • Timely completion of special projects

Key Requirements

  • High school degree or equivalent
  • 4-5 years relevant healthcare experience
  • 3 years dedicated coding experience
  • Current coding certification from AAPC or AHIMA
  • Working knowledge of ICD and CPT code sets
  • Understanding of payer clinical and reimbursement policies

Work Rights

Not specified

Tailored Resume

Cover Letter