Coding Denial And Resolution Specialist (ft- 1.0 Fte, Day Shift, Remote)
Bozeman Health
Montana, USA
Fully remote
Resolve post-billed coding denials
Validate denial rationale
Submit and track payer appeals
Responsible for reviewing and resolving post-billed coding-related denials and rejections for hospital and medical group claims to support accurate reimbursement and denial prevention
Job Summary
Responsible for reviewing and resolving post-billed coding-related denials and rejections for hospital and medical group claims to support accurate reimbursement and denial prevention.
Applies expertise in ICD-10, CPT, and HCPCS to validate denial rationale, determine root cause, and recommend corrective actions.
Collaborates with coding, billing, clinical, compliance, and information systems partners to reduce avoidable denials and provide education on coding best practices.
Matching Summary
Responsible for reviewing and resolving post-billed coding-related denials and rejections for hospital and medical group claims to support accurate reimbursement and denial prevention.
Skills & Requirements
Must-have
Resolve post-billed coding denials
Validate denial rationale
Submit and track payer appeals
Analyze denial trends
Provide coding education
Nice-to-have
Collaborate with cross-functional teams
Maintain professional demeanor
Adapt to new applications
Key Requirements
Associate's Degree or equivalent experience
Current coding certification (CCA, CPC, CCS, CCS-P, CPMA, RHIA, or RHIT)
Three (3) years' experience in advanced coding
Proficiency with Microsoft Office Suite
Work Rights
Must relocate to Montana or approved states if not listed