Coding Denials Auditor (Medical Coder)

The Coding Denials Auditor is responsible for reviewing, auditing, and accurately coding inpatient, outpatient, and professional claims to ensure proper reimbursement, compliance with billing regulations, and adherence to coding standards. This role collaborates with revenue cycle teamsand serves as a subject matter expert on coding practices, with a special focus on claim denials and appeals.

Key Responsibilities

• Conducts coding audits of submitted claims to determine appropriateness of procedure and diagnosis codes billed based on documentation provided for inpatient and outpatient facility claims as well as professional claims.

• Reviews billing for accuracy to ensure compliance of proper billing and coding procedures of third-party carriers and to ensure complete and accurate reimbursement.

• Coordinates with revenue cycle teams to investigate rejected or denied claims to determine denial accuracy and ...