Physician Coding and Denial Specialist

Physician Coding and Denial Specialist (11045)

Join to apply for the Physician Coding and Denial Specialist (11045) role at Cullman Regional Medical Center.

• Analyzes claim denials and executes follow up to recover maximum reimbursement.
• Performs patient billing and insurance claims filing.
• Analyzes medical records to assign appropriate diagnosis codes following coding guidelines.
• Analyzes medical records to assign appropriate procedure codes following coding guidelines.
• Performs analysis of medical records to rectify charge entry and modifiers based on documentation.
• Assists with claim submission, follow‑up, and reporting needs throughout the clinically‑driven revenue cycle.
• Submits payer appeals as necessary and completes follow‑up for final resolution.
• Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement.
• Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials.
• Enters accurate and thorough documentation of pertinent events regarding the handling of the denial.
• Meets established production standards.
• Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes.

• High school diploma or equivalent required.
• Completion of Medical Coding from an approved Health Information Technology Program; currently a Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) is required.
• Minimum three (3) years working in Medical Billing & Coding.
• Must be self‑directed and self‑motivated; must have good communication and interpersonal skills.
• Must be able to perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; work independently; recognize the rights and responsibilities of patient confidentiality; relate to others in a manner which creates a sense of teamwork and cooperation; and maintain a customer focus and strive to satisfy the customer’s perceived need.