Denials Coder

1 day ago

Manila, National Capital Region, Philippines RemoteRaven Full time
Certified Professional Coder (CPC) – Denial Management Specialist

We are looking for a highly analytical and detail-oriented Certified Professional Coder (CPC) to join our growing team. This role is focused on Denial Management, Revenue Integrity, and supporting the full revenue cycle process. If you are a coder who can investigate, problem-solve, and turn denials into recoverable revenue, we want to meet you.


Key Responsibilities
Denial Management & Coding
  • Review and resolve complex claim denials related to CCI edits, medical necessity, bundling, and modifier issues.
  • Perform hard coding directly from medical documentation with accuracy in ICD-10-CM, CPT, and HCPCS.
  • Prepare and submit detailed appeal letters following AMA and CMS guidelines.
  • Identify trends in coding denials and provide feedback to help prevent future claim rejections.
Billing & Revenue Cycle Support
  • Support the full lifecycle of a claim, ensuring corrected codes are updated and rebilled properly.
  • Verify insurance eligibility and coverage for denial-related issues.
  • Coordinate with the AR team to follow up on outstanding claims.
Communication & Inbound Support
  • Handle inbound calls from patients regarding billing inquiries and from insurance representatives regarding claim status.
  • Communicate with providers to clarify documentation gaps affecting coding accuracy.
  • Perform additional RCM-related tasks as assigned.

Qualifications
  • Required: Active CPC certification (AAPC).
  • Preferred: 2+ years of coding experience with strong exposure to denial buckets.
  • Strong knowledge of anatomy, physiology, and medical terminology.
  • Experience working with EMR/EHR systems (e.g., Epic, eClinicalWorks, NextGen) and clearinghouses.

Preferred (Advantageous) Experience
  • Expertise in hard coding from source documentation.
  • Background in medical billing (payment posting, claim scrubbing, AR follow-up).
  • Call center or high-volume customer service experience within healthcare.

Key Competencies
  • Investigative mindset — able to identify the root cause of denials.
  • Resilience — persistence in payer follow-ups until resolution.
  • Strong attention to detail — especially when reviewing clinical documentation and payer policies.

How to Apply

Send your resume to

Subject line: Jobstreet Applicant | Certified Professional Coder | Complete Name

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