Pn Cert Prof Coding Denial Specialist

Cook Children's Health Care System

Remote, TX, US
Fully remote
Complex coding denial resolution
Cms ama aapc guideline application
Icd and cpt code set knowledge
The specialist is responsible for reviewing and determining the root cause of complex coding denials for all providers within the network

Job Summary

  • The specialist is responsible for reviewing and determining the root cause of complex coding denials for all providers within the network.
  • This role requires actively communicating with payers to defend code assignments and successfully appealing coding-related denials using governing entity guidelines.
  • Cook Children's is a not-for-profit organization dedicated to providing top-ranked specialty programs and comprehensive care for children throughout Texas.

Matching Summary

The specialist is responsible for reviewing and determining the root cause of complex coding denials for all providers within the network.

Skills & Requirements

Must-have

  • Complex coding denial resolution
  • CMS AMA AAPC guideline application
  • ICD and CPT code set knowledge
  • Electronic health record proficiency
  • Payer clinical policy understanding

Nice-to-have

  • Strong interpersonal communication skills
  • Microsoft Excel proficiency
  • Advanced medical terminology expertise
  • Collaborative team environment
  • Pediatric healthcare focus

Key Requirements

  • High school degree or equivalent
  • 4-5 years relevant healthcare experience
  • 3 years dedicated coding experience
  • Current AAPC or AHIMA certification required
  • Remote work in Texas

Work Rights

Not specified

Tailored Resume

Cover Letter