Denial Coding Specialist

About Paix Services

Paix Services, a U.S.-based subsidiary of Holy Name headquartered in New Jersey, is dedicated to delivering innovative software solutions that enhance healthcare operations and efficiency. Our parent organization, Holy Name, is a respected healthcare provider committed to community-driven services and leveraging technology for improved patient care. Paix Services provides cutting-edge tools to address critical needs in healthcare management.

Job Description

We are seeking experienced Denial Coding Specialists with a strong background in coding review and correction. This position involves analyzing denied claims from a coding perspective and offering coding recommendations to the Accounts Receivable (AR) teams to facilitate claim resolution. The role requires a thorough understanding of medical coding systems and their impact on claim denials within the US Healthcare Revenue Cycle Management (RCM) landscape.

Key Responsibilities

• Conduct comprehensive reviews of denied claims, focusing on coding accuracy and compliance.
• Execute precise coding corrections using ICD-10, CPT, and HCPCS codes.
• Determine and document coding-related reasons for claim denials.
• Formulate and communicate actionable coding suggestions and recommendations to the AR Caller team.
• Ensure all coding practices adhere strictly to established coding guidelines and specific payer requirements.
• Consistently uphold high standards of quality and accuracy in all coding-related tasks.

Required Skills

• Proficiency in ICD-10, CPT, and HCPCS coding systems.
• Demonstrated experience in denial coding, coding audits, or coding reviews.
• Solid comprehension of claim denial causes from a coding perspective.
• Familiarity with US Healthcare and Revenue Cycle Management (RCM) processes.
• Strong analytical and problem-solving capabilities.

Preferred Qualifications

• Possession of a CPC, CCS, or CIC certification is highly desirable.
• Experience in multi-specialty medical coding is advantageous.

Additional Information

Interested candidates are invited to apply by emailing their resume to sajeethkumar@paixservices.com or contacting via WhatsApp at 6385155476.