Coder, Edits/Denials

Ovation Healthcare seeks an Edit & Denials Coder to review medical records, perform advanced coding, investigate payer issues, and file appeals to insurance companies, supporting independent hospitals and health systems.

Location: United States

Responsibilities

• Review documentation in medical records to identify facts for appealing denied claims and create supporting letters.
• Meet with facility liaison to review documentation, resolve coding issues, and develop appeals.
• Research payer policies and processes.
• Review clinical documentation to select diagnoses and procedures that describe patient conditions and treatments.
• Work assigned queues, review remittance advice for rejections, and identify rejected claims.

Requirements

• Knowledge of ICD-10 and CPT Coding.
• Comfortable working with AR teams to resolve issues.
• Able to pass a coding assessment.
• Proficient in Microsoft Office (Outlook, Excel, Teams).
• Ability to multi-task and communicate effectively.
• Maintain 95% quality accuracy and productivity standards.
• Apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics.
• Experience working in a remote environment.

Additional Information

• Requires CCS, AHIMA, CCS-P, CPC, AAPC, CPC-A, or AAPC Credentials.
• Minimum of three years of coding experience.
• Reliable high-speed internet and a HIPAA-compliant work environment are required.