Multispecialty Denials Coding Specialist

Professional Credit | Ensource specializes in accounts receivable management services offering two dedicated service lines: Professional Credit collections, and Ensource, premier provider of domestic, high-quality medical coding and revenue cycle management (RCM) services. They use cutting-edge technology to support clients and focus on consumer-centric financial services that enhance client-consumer relations.

As a Multispecialty Denials Coding Specialist, you will review documentation and coding for professional fee-based coding, evaluation and management services, procedures, and diagnoses. Responsibilities include researching claim denials, submitting appeals, following up on outstanding claims, and handling claims correspondence.

This role is full-time and remote.

Key duties:

• Research payer denials related to referral, pre-authorization, eligibility/registration, notifications, medical necessity, non-covered services, and billing.
• Submit detailed, customized appeals based on medical records review and in accordance with Medicare, Medicaid, third-party guidelines, and client policies.
• Submit retro-authorizations in response to authorization denials.
• Identify root causes of claim issues and propose resolutions for timely payments.
• Ensure appropriate revenue capture to prevent audits, litigation, and denials.

Requirements:

• Proficiency with MS Office Suite and Athena software.
• Minimum 2 years in profee multispecialty, E/M coding.
• Minimum 5 years physician-based denials experience.
• Relevant certifications such as AAPC CPC and/or AHIMA CCS, CCS-P, or RHIT.
• Knowledge of medical terminology, insurance, appeals processes, and medical record management.
• High accuracy and attention to detail.
• Strong communication skills.

Reasons to join:

• Flexible schedules for work-life balance.
• Remote work with team socials and collaboration.
• Growth potential.
• Health, dental & vision insurance benefits.
• 401k/Roth plan with discretionary matching.
• Paid time off for full- and part-time employees.
• Yearly stipend for educational CEU resources.
• Paid volunteer and community outreach programs.

Work 35-40 hours per week in this remote opportunity.