EnableComp provides specialty revenue cycle management solutions for healthcare organizations, with a focus on complex claims, denials, and reimbursement optimization. The company supports hospitals, health systems, and ambulatory surgery centers nationwide through its E360 RCM intelligent automation platform.
The Coding Denials Auditor is responsible for analyzing coded medical services, reports, records, and billed charges to determine whether medical coding, delivery of care, and treatment plans are appropriate. This role involves reviewing claims for coding accuracy, investigating denied or rejected claims, supporting correction and appeal activities, and communicating findings internally and externally.
Key duties include conducting coding audits, drafting appeals using nationally recognized coding guidance, collaborating with revenue cycle teams, and using Microsoft Office tools to create correspondence, charts, spreadsheets, and other work products.
Associate's or bachelor's degree.
Current certification in one of the following:
- CPC
- CCA
- CCS
- RHIT
5+ years of experience in orthopedic surgery billing/coding, with a strong background in medical billing, AR, EOBs, account management, and coding denials.
Additional requirements:
- Ability to gather and analyze claims and medical records information
- Strong written communication skills
- Ability to draft clear, grammatically correct appeals using CPT Assistant, specialty society guidance, state fee schedules, and AAPC/AHIMA resources
- Strong time management skills and the ability to work independently
- Analytical, problem-solving, and research skills
- Comfort with CAC/Encoder audits and code selection based on audit findings
- Familiarity with healthcare documentation systems
- Experience with DRGs, APCs, and NCCI concepts
- Strong verbal, written, interpersonal, and customer service skills
- Ability to communicate audit findings to both medical and non-medical staff
- Strong computer proficiency, including Word, Excel, and Outlook
- Regular and predictable attendance
Equivalent combination of education and experience will be considered.
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago