Insurance Claims Specialist

To enhance revenue recovery, the remote Denials Specialist will review documentation for accuracy in diagnoses and procedure codes, resolve claim denials related to coding and billing, and identify trends to prevent future issues. Key responsibilities: Review provider documentation to ensure accurate reporting of diagnoses and procedure codes Research coding policies and payer guidelines to resolve claim denials Identify trends in denials and provide feedback for process improvements Required qualifications: Professional coding certification such as CPC, CCS, CIC, or COC with 1 year of experience in a coding-related denials management role Experience with complex surgical specialties and interventional radiology is a plus Familiarity with Athena is preferred Strong working knowledge of CPT, HCPCS, ICD-10-CM/PCS, modifiers, and NCCI edits Knowledge of payer contracts and reimbursement methodologies