Currance
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Remote position available in multiple states: AR, AZ, CA, CO, FL, GA, IA, IL, LA, MA, ME, MO, NC, NE, NV, OK, PA, SD, TN, TX, VA, WA, WI.
Job Overview The Coding Denial Resolution Specialist I plays a vital role in Operations, working remotely and responsible for identifying, investigating, and resolving coding-related denials from payers. The role involves timely, accurate, and thorough corrections and appeals for assigned accounts, identifying root causes, ensuring compliance with regulations, and collaborating with internal and client teams to maximize reimbursements.
Job Duties and Responsibilities
Execute tasks focused on revenue generation through account resolution for any company client.
Review documentation to support or contest payer coding decisions for multiple facilities.
Prepare clear, concise, and well‑supported appeals with applicable documentation, coding guidelines, and regulatory references to defend billed claims and secure reimbursement.
Investigate root causes of denials and downgrades as needed.
Provide targeted training on coding practices to Currance team members.
Participate in daily shift briefings and contribute actively.
Resubmit corrected claims according to federal, state, and payer‑mandated guidelines.
Research, analyze, and correct claim errors and rejections to ensure accurate resubmission and avoid payer denials.
Escalate problematic accounts, recurring issues, or trends to supervisor and recommend education or denial prevention measures.
Stay current on payer updates, process changes, and coding guidelines to maintain compliance.
Meet productivity standards while maintaining quality output.
Communicate payer‑specific issues to team and management for timely resolution.
Engage in continuous learning to stay up to date on coding and payer policies.
Performance Expectations
Productivity: Achieve 100% of the daily project goal.
Quality: Achieve 95% monthly quality assurance score.
Other expectations as outlined by the department.
Qualifications
High school diploma or equivalent (GED) required.
Associate or bachelor’s degree in healthcare management, Health Information Management/Technology (HIM/HIT) preferred.
Current/active CCS or CPC certification required.
Minimum of 3 years’ experience resolving payer denials and/or conducting coding audits.
Experience in medical claim payments, follow‑up, and appealing denials with proven success on complex, high‑value claims.
Advanced knowledge of ICD‑10, CPT/HCPCS, NCCI edits, DRG/APC assignment, payer policies, and reimbursement regulations.
Strong negotiation, research, written communication, and problem‑solving skills.
Experience correcting and resubmitting denied claims due to coding issues.
Ability to research regulatory references and apply them to appeals.
Demonstrated ability to analyze denial trends and recommend process or coding improvements.
Familiarity with compliance standards (OIG, CMS, HIPAA) related to coding and billing.
Experience using EHR/EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms for billing and account resolution.
Ability to collaborate effectively with other coders, clinicians, and account resolution specialists.
Proficiency in Microsoft Office Suite, Teams, and desktop applications.
Knowledge, Skills, and Abilities
Understanding of ICD‑10 diagnosis and procedure codes, and CPT/HCPCS codes.
Familiarity with regulations related to Healthcare Revenue Cycle administration.
Skill in investigating medical accounts and resolving claims.
Ability to validate payments and make informed decisions quickly.
Capacity to learn and use collaboration and messaging tools effectively.
Positive attitude and pleasant demeanor, acting in the best interests of organization and client.
Professional commitment to quality and timeliness of work.
Capacity to achieve results with minimal supervision while balancing priorities.
Strong organizational skills to manage high‑volume workloads and meet deadlines.
Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, wellness focus, and work‑life balance support.
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Remote position available in multiple states: AR, AZ, CA, CO, FL, GA, IA, IL, LA, MA, ME, MO, NC, NE, NV, OK, PA, SD, TN, TX, VA, WA, WI.
Job Overview The Coding Denial Resolution Specialist I plays a vital role in Operations, working remotely and responsible for identifying, investigating, and resolving coding-related denials from payers. The role involves timely, accurate, and thorough corrections and appeals for assigned accounts, identifying root causes, ensuring compliance with regulations, and collaborating with internal and client teams to maximize reimbursements.
Job Duties and Responsibilities
Execute tasks focused on revenue generation through account resolution for any company client.
Review documentation to support or contest payer coding decisions for multiple facilities.
Prepare clear, concise, and well‑supported appeals with applicable documentation, coding guidelines, and regulatory references to defend billed claims and secure reimbursement.
Investigate root causes of denials and downgrades as needed.
Provide targeted training on coding practices to Currance team members.
Participate in daily shift briefings and contribute actively.
Resubmit corrected claims according to federal, state, and payer‑mandated guidelines.
Research, analyze, and correct claim errors and rejections to ensure accurate resubmission and avoid payer denials.
Escalate problematic accounts, recurring issues, or trends to supervisor and recommend education or denial prevention measures.
Stay current on payer updates, process changes, and coding guidelines to maintain compliance.
Meet productivity standards while maintaining quality output.
Communicate payer‑specific issues to team and management for timely resolution.
Engage in continuous learning to stay up to date on coding and payer policies.
Performance Expectations
Productivity: Achieve 100% of the daily project goal.
Quality: Achieve 95% monthly quality assurance score.
Other expectations as outlined by the department.
Qualifications
High school diploma or equivalent (GED) required.
Associate or bachelor’s degree in healthcare management, Health Information Management/Technology (HIM/HIT) preferred.
Current/active CCS or CPC certification required.
Minimum of 3 years’ experience resolving payer denials and/or conducting coding audits.
Experience in medical claim payments, follow‑up, and appealing denials with proven success on complex, high‑value claims.
Advanced knowledge of ICD‑10, CPT/HCPCS, NCCI edits, DRG/APC assignment, payer policies, and reimbursement regulations.
Strong negotiation, research, written communication, and problem‑solving skills.
Experience correcting and resubmitting denied claims due to coding issues.
Ability to research regulatory references and apply them to appeals.
Demonstrated ability to analyze denial trends and recommend process or coding improvements.
Familiarity with compliance standards (OIG, CMS, HIPAA) related to coding and billing.
Experience using EHR/EMR systems such as Meditech, Epic, Cerner, Allscripts, Nextgen, or similar platforms for billing and account resolution.
Ability to collaborate effectively with other coders, clinicians, and account resolution specialists.
Proficiency in Microsoft Office Suite, Teams, and desktop applications.
Knowledge, Skills, and Abilities
Understanding of ICD‑10 diagnosis and procedure codes, and CPT/HCPCS codes.
Familiarity with regulations related to Healthcare Revenue Cycle administration.
Skill in investigating medical accounts and resolving claims.
Ability to validate payments and make informed decisions quickly.
Capacity to learn and use collaboration and messaging tools effectively.
Positive attitude and pleasant demeanor, acting in the best interests of organization and client.
Professional commitment to quality and timeliness of work.
Capacity to achieve results with minimal supervision while balancing priorities.
Strong organizational skills to manage high‑volume workloads and meet deadlines.
Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, wellness focus, and work‑life balance support.
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