Revenue Cycle Coder Denial Specialist

At Proliance Surgeons our patients come from all walks of life — and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered.

We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at www.proliancesurgeons.com/careers. Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity.

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Position Summary

We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist to join our team. This role plays a key part in identifying denial trends, supporting Accounts Receivable (AR) workflows, and driving resolution through research, coding review, and appeal preparation.

The ideal candidate brings strong coding expertise, sharp critical thinking skills, and a solid understanding of the full-billing and reimbursement lifecycle. This position also serves as a coding float, providing flexible support and coverage across coding teams as needed.

Key Duties and Responsibilities

• Review and analyze denied claims to determine root cause and appropriate resolution
• Identify denial trends and collaborate with coding, billing, and AR teams to improve outcomes
• Prepare and submit detailed, compliant appeal letters with supporting documentation
• Perform coding reviews to ensure accuracy and alignment with payer guidelines, CPT, ICD-10-CM, and HCPCS standards
• Partner with AR team members to resolve complex accounts and reduce aging receivables
• Communicate with providers and staff to obtain necessary documentation or clarification
• Assist with education and feedback to coding and billing staff based on denial findings
• Maintain up-to-date knowledge of payer policies, regulatory requirements, and coding updates
• Provide coding support across specialties as needed in a float capacity
• Participate in process improvement initiatives to enhance revenue cycle performance
• Demonstrate appropriate utilization of coding software and coding reference material
• Follow up with providers on any documentation that is insufficient, missing, or unclear
• Assist providers with coding and documentation guideline questions, provide ongoing feedback, and identify opportunities for education
• Keep up to date on carrier policies/guidelines to ensure compliance with Medicare, National Correct Coding Initiative (NCCI), or other payer-specific guidelines

Education/Experience

• Minimum 3 years of coding/medical billing experience
• Active certification with credentialing from AHIMA and/or AAPC, maintained annually
• ICD10 certified and/or extensive work experience
• Strong understanding of medical terminology, anatomy, and physiology
• Experience with denial management, AR workflows, and appeals
• Orthopedic coding experience strongly preferred
• Experience with NextGen and SIS systems preferred

Knowledge, Skills and Abilities

• Strong understanding of physiology, medical terms, and anatomy
• Thorough attention to detail
• Excellent written and verbal communication skills
• Self-motivated team player able to multi-task and prioritize
• Excellent organization and interpersonal communication skills
• Strong computer skills including Microsoft Excel, Outlook, and Adobe
• Experience navigating EHRs to abstract documentation

Work Environment/Physical Demands

Work environment includes office and clinical settings. Requires corrected vision and hearing to normal range. Frequent sitting, standing, walking, bending, stretching, use of telephone and computer. Manual dexterity required for keyboard use. Occasionally lifts up to 40 pounds. May require working under stressful conditions or irregular hours.