Supervisor, Coding Denials

As a Coding Denial Supervisor, you will be responsible for providing direction to a team of Coding Denial Specialists to work on assigned claim edits and rejection work queues. Your role will involve ensuring timely investigation and resolution of health plan denials, as well as assisting in determining appropriate actions and providing resolutions for such denials. Key Responsibilities: - Ensure timely investigation and resolution of health plan denials - Implement and maintain policies and procedures for denial management - Provide training and support to team members to enhance their skills and knowledge - Escalate coding and processing issues based on denial trending Qualification Requirements: - Five years of experience in physician medical billing with an emphasis on research and claim denials - Graduation with a background in life sciences; paramedic/alternate medicine background is preferred - Valid AAPC/AHIMA coding certification; specialty certification is preferred In this role, you will need to have knowledge of health insurance, including coding, as well as a thorough understanding of physician billing policies, procedures, and healthcare reimbursement guidelines. You should also be familiar with AHA Official Coding and Reporting Guidelines, CMS, and other agency directives for ICD-10-CM and CPT coding. Being computer literate with working knowledge of Excel will be helpful as you navigate a fast-paced environment. Strong organizational and analytical skills, along with the ability to work independently and communicate effectively, are essential for success in this position. Additionally, the ability to work collaboratively with others, utilize basic computer tools, and comply with company policies and procedures will be expected. Your strong oral, written, and interpersonal communication skills, coupled with proficient computer skills, including Outlook, Word, Excel (pivot tables), and database software, will be valuable assets in fulfilling your responsibilities as a Coding Denial Supervisor.,