Coding Denial Resolution Specialist

Job Description

Job Description

Description : We are hiring in the following states :

AR, AZ, CA, CO, FL, GA, IA, IL, LA, MA, ME, MO, NC, NE, NV, OK, PA, SD, TN, TX, VA, WA, and WI

This is a remote position .

At Currance, we believe in recognizing the unique skills and experiences that each candidate brings to our team. Our overall compensation package is competitive and is determined by a combination of your experience in the industry and your knowledge of revenue cycle operations. We are committed to offering a rewarding environment that aligns with both individual contributions and our company goals.

Benefits include paid time off, 401(k) plan, health insurance (medical, dental, and vision), life insurance, paid holidays, training and development opportunities, a focus on wellness and support for work-life balance, and more.

Please note that we are looking for people who have hospital billing experience in collections and have some HB billing experience, in high dollar collections, adjustments and denials management.

Job Overview

The Coding Denial Resolution Specialist I plays a vital role in Operations, working remotely and responsible for clearly identifying, investigating, and resolving coding-related denials from payers. This position helps prevent lost reimbursements and supports denial prevention efforts. This role is responsible for timely, accurate, and thorough corrections and appeals for all assigned accounts, identifying the root causes of denials, and ensuring compliance with local, state, and federal regulations, as well as accrediting body guidelines. They are expected to resubmit corrected claims accurately, resolve coding denials effectively, and maximize client reimbursements by collaborating with internal and client teams.

Job Duties and Responsibilities

• Execute tasks focused on revenue generation through account resolution for any company client.
• Review documentation to support or contest payer coding decisions for multiple facilities.
• Prepare clear, concise, and well-supported appeals where applicable, using all available documentation, coding guidelines, and regulatory references to defend billed claims and secure reimbursement on insurance accounts receivable.
• Investigate the root causes of denials and downgrades, as needed.
• Provide targeted training on coding practices to Currance team members, promoting accuracy, compliance, and efficiency in resolving coding-related issues.
• Participate in daily shift briefings and contribute actively.
• Resubmit corrected claims according to Federal, State, and payer-mandated guidelines.
• Research, analyze, and correct claim errors and rejections to ensure accurate resubmission and to avoid payer denials due to preventable errors.
• Escalate problematic accounts, recurring issues, or trends to Supervisor and recommend education or denial prevention measures to the client.
• Stay current on payer updates, process changes, and coding guidelines to maintain compliance with Federal, State, and payer requirements.
• Meet productivity standards while maintaining quality output.
• Communicate payer-specific issues to the team and management for timely resolution.
• Engage in continuous learning to remain up to date on coding and payer policies.

Requirements :

Performance Expectations

Qualifications

Knowledge, Skills, and Abilities

Disclosure Statement :

As part of the Currance application and hiring experience, all candidates are subject to a criminal background check and a government exclusion check. The government exclusion check is a mandatory screening process that verifies whether an individual is listed on federal or state exclusion or watchlists, including but not limited to, the Office of Inspector General’s List of Excluded Individuals / Entities (LEIE) and the System for Award Management (SAM.gov).

These screenings are conducted to ensure compliance with applicable federal and state laws and regulations, to protect the integrity of federally funded programs, the clients we support, and to prevent participation by individuals who are excluded due to fraud, abuse, or other misconduct. By submitting an application, candidates acknowledge and consent to these checks as a condition of employment or engagement.