Coding Denials Auditor

EnableComp

. Conduct coding audits of submitted outpatient facility and professional claims .

Posted 10/2/2026full-timeRemote • Tennessee • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in medical coding and billing, particularly in orthopedics and surgery, with a strong ability to analyze claims and draft appeals. Proficient in using coding guidelines and healthcare documentation systems to ensure compliance and accuracy in billing processes.

Highest-signal resume keywords

CPC CertificationOrthopedic Surgery Billing ExperienceClaims AnalysisMedical Coding ExpertiseMicrosoft Office Proficiency

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medical CodingBilling AccuracyClaims CorrectionsCPT Assistant UsageAR ManagementEOB AnalysisCAC/Encoder AuditsDRGs KnowledgeAPCs KnowledgeNCCI Fee Schedule Concepts

Soft Skills

Strong Written CommunicationAnalytical SkillsProblem-Solving SkillsTime ManagementInterpersonal Communication

Tools & Technologies

Microsoft Office SuiteHealthcare Documentation Systems

Certifications & Qualifications

CPCAAPC-related CertificationCCACCSRHIT

Industry Keywords

Outpatient Facility ClaimsThird-Party Carrier ComplianceRevenue Cycle CoordinationClaim DenialsPayer Appeals

About the role

Key responsibilities & impact

Conduct coding audits of submitted outpatient facility and professional claims
Review billing accuracy and compliance with third-party carrier billing and coding procedures
Coordinate with revenue cycle teams to investigate rejected or denied claims
Assist with claim corrections and appeals through inter-departmental collaboration
Use Microsoft Office Suite to produce correspondence, charts, spreadsheets, and related information
Maintain knowledge of medical coding and healthcare market changes
Gather and analyze claims and medical records information to assess documentation findings and outcomes
Draft payer appeals using nationally sourced coding guidelines
Communicate coding expertise and audit outcomes internally and externally
Perform other duties as required

Requirements

What you’ll need

Associate's or Bachelor's Degree
Current certification: CPC, AAPC-related certification, CCA, CCS, or RHIT
Strong background in orthopedics and surgery billing/coding
Ideal candidate has 5+ years of orthopedic surgery billing experience
Background in coding and medical billing, including AR, EOBs, account management, and coding denials
Ability to gather and analyze claims and medical records information
Strong written communication skills
Ability to draft grammatically correct appeals using CPT Assistant, specialty society guidance, state fee schedules, and AAPC/AHIMA articles
Sound time management and ability to manage workload independently
Strong analytical, problem-solving, research, and creative-thinking skills
Comfort with CAC/Encoder audits and identifying appropriate code selection
Equivalent combination of education and experience considered
Ability to work remotely
Strong computer proficiency, including Microsoft Word, Excel, and Outlook
Regular and predictable attendance
Familiarity with healthcare documentation systems
Experience with DRGs, APCs, and NCCI fee schedule concepts
Strong verbal, written, interpersonal communication, and customer service skills
Ability to communicate audit outcomes and testing results to medically and non-medically oriented staff
Ability to interpret policies and procedures and communicate complex topics
Ability to think critically and make decisions within role responsibilities
Complex Claims medical billing and coding experience strongly preferred

Benefits

Comp & perks

Professional growth and development opportunities
Tools, resources, and support for career development
Flexible, family-oriented work culture
Work-life balance support
Remote work option