Coding Denials Specialist – Clinical Practice Services

Job not on LinkedIn

🔥 0 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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MCW

WebsiteLinkedInAll Job Openings

1 - 10 employees

Founded 2021

🚘 Automotive

📦 Logistics

🚗 Transport

Automotive • Logistics • Transport

MCW is Mythical Cars Worldwide, a French automotive services company that assists clients with vehicle importation into France, road transport and logistics for cars, motorcycles, caravans, trailers and boats, and performance engine reprogramming/tuning. MCW also supplies performance parts, custom exhausts, vehicle covering (wraps) and detailing, and helps customers find and source vehicles to match their preferences.

📋 Description

• Research payer denials related to coding, documentation, referral, pre-authorization, notifications, medical necessity, non-covered services, and billing • Review claim denials, account/guarantor notes, and medical records to determine required action • Determine whether revised claims, retro authorizations, written appeals, or no action are needed • Write and submit professionally written appeals based on clinical documentation, payer medical policies, and contract language • Submit customized appeals in accordance with Medicare, Medicaid, third-party guidelines, and MCW/CPS compliance policies • Collaborate with the prior authorization team to obtain retro-authorizations • Identify denial patterns and escalate issues for follow-up or root cause resolution • Recommend changes to work queues and claim edits to improve efficiency and reduce denials • Review payer communications and identify reimbursement risks related to medical policies and prior authorization requirements • Escalate potential issues to clinical stakeholders, managed care contracting, and Revenue Cycle leadership • Identify process improvement opportunities and participate in process improvement initiatives • Perform other duties as assigned

🎯 Requirements

• High school diploma • Five (5) years of experience in a health care setting, working in coding and/or reimbursement follow up • Certified professional coder (CCS-P, CPC, or CCA) and/or health information management credential (RHIT or RHIA) • Knowledge of payer policies and claims requirements • Advanced knowledge of CPT, ICD-10 coding, payer and governmental policies • Proficiency with EMR’s (EPIC) and Microsoft Office • Effective communication skills and writing capabilities / efficiencies • Ability to manage multiple tasks with ease and efficiency • Effective interpersonal skills, including the ability to promote teamwork • Strong problem-solving skills

🏖️ Benefits

• Outstanding Healthcare Coverage, including Health, Vision, and Dental • Flexible Spending options • 403B Retirement Package • Competitive Vacation and Paid Holidays offered • Tuition Reimbursement • Paid Parental Leave • Employee & Family Assistance Program (EFAP) • Pet Insurance • On campus Fitness Facility, offering onsite classes • Discounted rates on select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment