Coding Denials Specialist Snellville, GA

Overview

Coding Denials Specialist – Snellville, GA

Job Title – Position

Description:

Coding and Coding Denials Specialist

Reports to: Coding Supervisor

MISSION

We are seeking a detail-oriented and knowledgeable Medical Coder with experience in claims scrubbing and denial management to join our Revenue Cycle team. The ideal candidate will be responsible for accurate CPT/ICD-10 coding, ensuring claims are clean and compliant before submission, and investigating and resolving denials from payers. This role plays a key part in optimizing reimbursement and reducing payment delays.

OUTCOMES

• Code medical procedures and diagnoses using CPT, ICD-10, and HCPCS codes based on provider documentation.
• Review and scrub claims for accuracy, completeness, and compliance with payer policies before submission.
• Identify and correct coding errors, mismatched modifiers, or billing inconsistencies that may lead to denials.
• Analyze claim denials and rejections
  , determine root causes, and coordinate appeals or corrections.
• Collaborate with providers, billing staff, and payers to resolve documentation or coding discrepancies.
• Keep current with coding regulations, payer guidelines, and compliance updates (Medicare, Medicaid, commercial insurers).
• Maintain accurate records of coding decisions, appeals, and resolution timelines.
• Assist in process improvements to reduce denial rates and enhance claim acceptance.

Job Related

Competencies:

Advanced Values:

Being Resilient:

• Rebounding from setback and adversity when facing difficult situations

Self-Development:

• Actively seeking new ways to grow and be challenged using both formal and informal development challenges

Optimizes Work Processes:

• Knowing the most effective and efficient processes to get things done, with a focus on continuous improvement

Professional Communication:

• Developing and delivering multi-mode communications that convey a clear understanding of the unique needs of different audiences, while maintaining a professional appearance and tone

Basic Qualifications:

Education:

• Certified Professional Coder (CPC) or equivalent credential (e.g., CCS, CCA, RHIT) – required.
• High School Diploma or GED

Previous Job Relevant

Work Experience:

• Experience with claim scrubbing tools or clearinghouse platforms (e.g., Trizetto, Waystar, Availity, Change Healthcare).
• Working knowledge of denial codes (CARC/RARC), payer rules, and appeal processes
  .
• Proficient with EHR and billing systems (
  eClinical Works )
• Strong attention to detail, organizational skills, and ability to meet deadlines.
• Excellent communication and problem-solving skills.
• 2+ years of medical coding experience, preferably in urology specialty;
  Previous experience in Urology Billing and Coding