UASI

DenialsSpecialist

Remote Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid+ candidates.

The Brief

“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.

Problems you'll solve

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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