Job Title

Denials Management Coder

Job Purpose

Responsible for reviewing denied claims for coding related errors and determining appropriate action. The Denials Management Coder will be responsible for corrections to individual accounts with include CPT and/or ICD-10 Corrections, applications of correct modifiers, etc. The coder is also responsible for ensuring that government and local guidelines are followed. Payers include but not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.

Duties and Responsibilities

• Read and interpret insurance carrier EOBs.
• Review medical reports, verify coding.
• Resolve coding related denial.
• Make any necessary coding corrections.
• Generate replacement claims (electronic and paper)
• Research carrier specific coding policies.
• Review and interpret carrier NCD and LCD policies.
• Communicate any coding deni...