Denial Coder

A Denial Coder reviews and resolves denied or rejected insurance claims by accurately identifying the reason for denial and taking corrective actions, often involving re-coding or appealing the claim. This role requires strong knowledge of medical coding (ICD-10, CPT, HCPCS), medical terminology, and the ability to analyze medical documentation. The Denial Coder works to minimize future denials by identifying trends and implementing preventative measures.

Key Responsibilities:

1>>Claim Review and Analysis:
Scrutinize denied or rejected insurance claims to determine the specific reason for denial.
2>>Accurate Coding:
Ensure accurate coding of diagnoses and procedures according to established guidelines.
3>>Root Cause Identification:
Investigate and identify the underlying reasons for claim denials, such as incorrect coding, lack of medical necessity, or missing documentation.
4>>Claim Resubmission and Appeals:
Resubmit corrected claims or prepare and submit appeals to insurance payers, often including gathering supporting documentation.
5>>Denial Prevention:
Contribute to the development and implementation of strategies to prevent future denials by identifying trends and recommending process improvements.
6>>Communication and Collaboration:
Communicate effectively with billing staff, clinical documentation specialists, and other relevant parties regarding claim denials and resolutions.
7>>Documentation:
Maintain accurate records of denial trends, resolutions, and preventative actions taken.

🌟 HIRING MEDICAL CODERS🌟

📅 Experience: 1 – 4 Years
📜 Requirement: Certified Coders Only
🏢 Mode: Work From Office