Coding Denials & Edits Specialist, AAPC/AMHIMA Certification Required

CorroHealth

. Interact with insurance plans, patients, physicians, attorneys, and fellow team members as needed .

Posted 11/3/2026full-timeRemote • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in healthcare revenue cycle management, including claims processing, patient eligibility verification, and denial resolution. Proficient in utilizing billing guidelines and EOB interpretation to ensure timely collection of healthcare insurance receivables.

Highest-signal resume keywords

Accounts Receivable ExperienceAAPC or AHIMA CertificationHealthcare Billing and ProcessingEOB InterpretationUB04 and HCFA 1500 Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingPatient Eligibility VerificationDenial ResolutionBilling Guidelines ResearchAnalytical SkillsBasic Mathematical SkillsClinical Audit PreparationTechnical Appeals WritingInsurance Claims ManagementPayment Verification

Soft Skills

Interpersonal SkillsProfessional CommunicationIndependent WorkCritical Thinking

Tools & Technologies

OutlookExcelWord

Certifications & Qualifications

AAPC CertificationAHIMA CertificationCPCRHIT

Industry Keywords

Healthcare Revenue CycleInsurance BillingClaims DenialsUB04HCFA 1500EOB

About the role

Key responsibilities & impact

Interact with insurance plans, patients, physicians, attorneys, and fellow team members as needed
Verify or obtain patient eligibility and authorization for healthcare services
Update patient demographics and insurance information in appropriate systems
Research and appropriately status unpaid or denied claims
Monitor claims for missing information, authorization, and control numbers (ICN/DCN)
Research EOBs for payments or adjustments to resolve claims
Contact payers by phone or written correspondence to secure claim payments
Access client systems for received payments, open claims, and other data needed to resolve claims
Follow prioritization guidelines, timely filing deadlines, and notation protocols
Secure medical documentation requested by third-party insurance carriers
Obtain billing guidelines and requirements by researching provider billing manuals
Work denials and code edits
Write appeal letters for technical appeals
Verify underpayment accuracy by researching contracts and claims data
Prepare claims for clinical audit processing when authorization, coding, level-of-care, or length-of-stay denials occur
Ensure timely collection of outstanding government or commercial healthcare insurance receivables
Report to the Manager, AR Services

Requirements

What you’ll need

3+ years of accounts receivable experience within the healthcare revenue cycle
Must have an AAPC or AHIMA certification such as CPC or RHIT
2+ years of experience with healthcare and/or insurance billing and processing
Experience with professional physician and hospital facility claims
Ability to read and interpret an EOB
Knowledge and understanding of UB04 and HCFA 1500 forms
High School diploma
Proficiency with Outlook, Excel, and Word
Ability to manage email, Outlook calendar, and tasks
Ability to perform basic formulas such as addition, subtraction, and multiplication
Ability to communicate in a professional and clear manner
Strong interpersonal skills
Ability to work independently
Analytical and critical thinking skills
Ability to perform computer-based work for 6–8 hours per day
Ability to lift and move material weighing up to 20 lbs. infrequently

Benefits

Comp & perks

Professional development and personal growth opportunities
Investment in employee career development