Coding and Denials Analyst
GeneDx
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $70,000 - $75,000 per year
About the role
- Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes in compliance with regulatory and payer requirements.
- Work daily custom coding, pricing, and patient/client inquiry queues, as applicable, to ensure prior authorization requests and claims are coded accurately, have appropriate pricing and in are compliance with regulatory and payer requirements.
- Investigate and resolve coding-related denials resulting in claim denials and delays in payment.
- Identify and analyze coding denial patterns from worklists and collaborate cross functionally on strategies to reduce revenue leakage.
- Collaborate with internal revenue cycle management teams to improve coding compliance.
- Serve as a medical coding resource and subject matter expert for cross functional teams.
- Participate in external audits to review coding integrity.
- Monitor coding changes, regulatory updates, and payer policy changes.
- Review reports on coding denials to support root cause analysis and coding accuracy.
- Participate in ad hoc medical coding related tasks, projects, and inquiries as directed by leadership.
- Complete other duties as assigned.
Requirements
- Associate’s degree in Business, Paralegal Studies, Coding, Communications, or other related field
- Minimum 2 years of medical coding experience in inpatient, outpatient, or professional services, with exposure to denial management and revenue cycle analytics.
- Strong knowledge of ICD-10-CM, CPT, HCPCS, medical terminology, payer guidelines, and reimbursement methodologies.
- Proficiency in EHR systems, coding software, and Microsoft Excel for data analysis and coding audits.
- Excellent analytical, communication, and problem-solving skills.
- Knowledge of payer guidelines and reimbursement methodologies.
- Ability to work independently and meet productivity/accuracy standards.
- Experience with denial management tools and reporting systems.
- Ability to interpret payer policies and regulatory requirements.
- Strong attention to detail and ability to meet productivity and accuracy standards.
- Experience working with third party payors.
- Excellent oral and written communication skills.
- Establish and maintain professional and cooperative relationships.
- Effective human relations abilities.
- Strong ability to effectively collaborative alliances and promote teamwork.
Benefits
- Paid Time Off (PTO)
- Health, Dental, Vision and Life insurance
- 401k Retirement Savings Plan
- Employee Discounts
- Voluntary benefits
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
ICD-10-CMCPTHCPCSmedical codingdenial managementrevenue cycle analyticsmedical terminologydata analysiscoding auditspayer guidelines
Soft Skills
analytical skillscommunication skillsproblem-solving skillsattention to detailindependenceteamworkrelationship buildingcollaborationhuman relations abilitiesproductivity standards
Certifications
Associate’s degree