Coding Denials & Appeals Auditor

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Assess inpatient and outpatient coding denials from commercial insurers.

• Examine medical records, coding, and documentation to identify potential appeal opportunities.

• Compose clear and clinically substantiated appeal letters for coding and medical necessity denials.

• Verify DRG, ICD-10, CPT, APC, and MS-DRG coding assignments.

• Decide when to appeal denials versus when to uphold them.

• Record denial and appeal activities within established workflows.

• Prioritize tasks based on potential recovery and financial implications.

• Collaborate effectively with coding, CDI, revenue cycle, and clinical teams.

• Leverage Epic and AI-driven appeal tools to bolster appeal development.

• Secure appropriate reimbursements through well-founded appeals.

⛳️ Requirements

• Current coding certification (CCS, CPC, RHIT, RHIA, or equivalent).

• Experience in acute-care coding with substantial knowledge of inpatient coding.

• Background in reviewing coding denials and drafting payer appeal letters.

• Familiarity with ICD-10, CPT, DRG, and coding compliance standards.

• Excellent critical thinking, analytical, and written communication abilities.

• High School Diploma or GED required.

• Availability for full-time work of 40 hours per week.

• Must be located in Richmond, Virginia, USA.

🏝️ Benefits

• 100% remote work opportunity.

• Flexible scheduling within a Monday to Friday workweek.

• Contract-to-hire position with potential for long-term career growth.

• Eligibility for quarterly incentives upon transitioning to permanent employment.

• Comprehensive medical, dental, and vision coverage.

• Critical illness, accident, and hospital insurance options.

• 401(k) retirement plan with pre-tax and Roth post-tax contribution options.

• Voluntary life and AD&D insurance for employees and their dependents.

• Short and long-term disability coverage.

• Health Spending Account (HSA) available.

• Transportation benefits offered.

• Employee Assistance Program access.

• Paid Time Off/Leave (PTO, vacation, or sick leave).