UASI
DenialsSpecialist
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Denials Specialist at UASI. Skills: coding, billing, denials management. reviewing documentation to ensure accuracy of diagnoses and procedure codes. resolving claim denials related to coding, billing, and payer policy compliance”
What You'll Achieve.
recover underpaid or denied revenue; prevent future denials
Industry & Context.
analytical skills
What They're Looking For.
Must Have
Professional coding certification such as CPC, CCS, CIC, or COC, 1 year of experience in a coding-related denials management role, Experience with a variety of denial types including medical necessity, timely filing, incorrect modifier usage, and unbundling of procedure codes, working knowledge of CPT®, HCPCS, ICD-10-CM/PCS Modifiers and NCCI edits, Medicare and commercial payer billing rules, attention to detail and analytical skills, Knowledge of payer contracts and reimbursement methodologies
Nice to Have
Experience with complex surgical specialties and interventional radiology (IR) is a plus, Familiarity with Athena is preferred
What You'll Do.
reviewing documentation to ensure accuracy of diagnoses and procedure codes
resolving claim denials related to coding
and payer policy compliance
identifying coding errors
and billing rule discrepancies to recover underpaid or denied revenue and prevent future denials
Review the provider's documentation to ensure all diagnoses and procedure codes were reported accurately
Complete charge corrections and update claims when coding corrections are needed
Identify claims that do not support billed CPT codes and take action as needed
Identify and resolve claims requiring adjustments by updating the billed E/M and procedure codes with a non-billable charge code
Identify trends and provide feedback to prevent future denials
Full Job Description
UASI is seeking several Denials Specialists with coding expertise to join our team! The Denials Specialist will be responsible for reviewing documentation to ensure accuracy of diagnoses and procedure codes and resolving claim denials related to coding, billing, and payer policy compliance. This role focuses on identifying coding errors, modifier issues, bundling conflicts, and billing rule discrepancies to recover underpaid or denied revenue and prevent future denials. Responsibilities: Review the provider's documentation to ensure all diagnoses and procedure codes were reported accurately. Research CMS LCD, NCD, NCCI Edit Policy, CPT Assistant, HCPCS Coding Clinics, payer guidelines, etc. Complete charge corrections and update claims when coding corrections are needed. Identify claims that do not support billed CPT codes and take action as needed. Identify and resolve claims requiring adjustments by updating the billed E/M and procedure codes with a non-billable charge code. Identify trends and provide feedback to prevent future denials. Qualifications Professional coding certification such as CPC, CCS, CIC, or COC and 1 year of experience in a coding-related denials management role. Experience with complex surgical specialties and interventional radiology (IR) is a plus but not required. Familiarity with Athena is preferred. Experience with a variety of denial types including medical necessity, timely filing, incorrect modifier usage, and unbundling of procedure codes. Strong working knowledge of CPT®, HCPCS, ICD-10-CM/PCS Modifiers and NCCI edits Medicare and commercial payer billing rules Strong attention to detail and strong analytical skills. Knowledge of payer contracts and reimbursement methodologies. UASI provides a supportive environment that encourages professional development and enables each employee to achieve their individual goals. We offer a competitive pay and excellent benefit package. Don’t pass on this great career opportunity! Interested candi
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