Denial Claims Analyst-RCM Specialist

5 days ago


West Long Branch, New Jersey, United States Allied Digestive Health Full time
About the Role

Allied Digestive Health is a leading gastroenterology care network with a strong commitment to delivering high-quality patient care. As a fast-growing organization, we prioritize physician input and decision-making while providing operational support.

We are seeking a highly skilled AR Denials and Escalation Analyst to join our team at our Corporate office in West Long Branch, NJ.

Key Responsibilities
  • Conduct medical coding audits to ensure compliance with regulatory guidelines.
  • Perform coding, billing, and documentation compliance audits within established timeframes.
  • Prepare reports of findings and recommendations for improvement.
  • Serve as a subject matter expert on coding and billing topics.
Requirements
  • 3+ years of experience in a professional audit capacity, with certifications in CPC, CRC, CGIC, and CGOC from AAPC.
  • Strong technical knowledge of IIA standards and CMS regulatory guidelines, including ICD-10 CM, CPT, and HCPCS Procedure Coding.
  • Proficiency in MS Office products, with intermediate to advanced knowledge of MS Excel.
  • Knowledge of Denials and Escalation processes.

Job Type: Fulltime



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