Job Description

Job Summary:

Coding Denial Supervisor to provide direction to a team of Coding Denial Specialists, who are responsible for working on assigned claim edits and rejection work queues. The Coding Denial Supervisor will ensure timely investigation and resolution of health plan denials. Additionally, the Coding Denial Supervisor will assist in determining appropriate actions and providing resolutions for health plan denials.


Essential Functions and Tasks:
Ensuring the timely investigation and resolution of health plan denials Assist in Implementing and maintaining policies and procedures for denial management Providing training and support to the team members to enhance their skills and knowledge Escalate coding and processing issues, based on denial trending.

Education and Experience Requirements:
Five years' experience in physician medical billing with emphasis on research and claim denials. Graduate with life science background, paramedic/alternate medicine background is preferred Valid AAPC/AHIMA coding certification; specialty certification is preferred

Knowledge, Skills, and Abilities:
Knowledge of health insurance, including coding. Thorough knowledge of physician billing policies and procedures. Thorough knowledge of healthcare reimbursement guidelines. Knowledge of AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-10-CM and CPT coding. Computer literate, working knowledge of Excel helpful. Able to work in a fast-paced environment. Good organizational and analytical skills. Ability to work independently. Ability to communicate effectively and efficiently.
Proficient computer skills, with the ability to learn applicable internal systems.

Ability to work collaboratively with others toward the accomplishment of shared goals.
Basic use of computer, telephone, internet, copier, fax, and scanner. Understand and comply with company policies and procedures. Strong oral, written, and interpersonal communication skills. Strong time management and organizational skills. * Strong knowledge of Outlook, Word, Excel (pivot tables), and database software skills.