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Healthcare Denials Coder at Remote Raven. Job Summary . We are seeking a detail-oriented and analytical Healthcare Denials Coder to join our dynamic team. The successful candidate will be responsible for investigating, analyzing, and resolving denied medical claims. This role is crucial to our revenue cycle, as it involves identifying the root causes of denials, correcting coding and billing errors, and submitting appeals to payers to ensure proper reimbursement for services rendered. The ideal candidate will possess a strong understanding of medical coding guidelines, payer policies, and the appeals process. .  . Key Responsibilities . Denial Analysis: Review and analyze all assigned denied, rejected, and underpaid claims to determine the root cause of the denial. This includes, but is not limited to, denials related to coding errors (ICD-10, CPT, HCPCS), bundling issues, medical necessity, prior authorization, and non-covered services. . Coding Correction: Utilize extensive knowledge of coding guidelines (AMA, CMS, and payer-specific) to accurately correct and resubmit claims. . Appeals Process: Prepare and submit compelling, well-documented appeals to various insurance carriers (Commercial, Medicare, Medicaid, etc.) in a timely manner. This includes writing professional appeal letters with supporting medical documentation. . Payer Communication: Communicate effectively with insurance companies to follow up on the status of appeals, clarify denial reasons, and negotiate resolutions. . Trend Identification: Identify and report on denial trends to management. Collaborate with other departments, such as coders, billers, and clinical staff, to implement preventative measures and reduce future denials. . Documentation: Thoroughly document all actions taken on a claim in the patient accounting system. . Stay Current: Keep up-to-date with changes in coding regulations, payer policies, and healthcare laws that may impact claim submission and reimbursement. . Collaboration: Work closely with the coding and billing teams to provide feedback and education on coding accuracy and denial prevention. . Manager or supervisor might assign tasks outside Key responsibilities and Scope of work. These tasks are limited to the purposes under the revenue cycle management. . Qualifications and Skills . Required: . Minimum of 1-3 years of experience in medical coding, billing, and/or denials management. . Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification from AAPC or AHIMA. . In-depth knowledge of ICD-10-CM, CPT, and HCPCS Level II coding systems. . Strong understanding of medical terminology, anatomy, and physiology. . Familiarity with various payer guidelines and the appeals process. . Proficiency with electronic health records (EHR) and medical billing software. . Excellent written and verbal communication skills. . Strong analytical and problem-solving abilities. . Exceptional attention to detail and a high degree of accuracy. . Ability to work independently and as part of a team in a fast-paced environment. .  . Preferred: . Bachelor's Degree in any healthcare or related field. . Experience with a DME and Sleep Medicine . Proven track record of successfully appealing and recovering denied claims. . Experience with denial management, AthenaOne, NikoHealth and Luma .  . Company Location: Philippines.