{"id":1735628,"url":"https://alion.io/job/enablecomp-coding-denials-auditor","title":"Coding Denials Auditor","company":{"id":4046,"name":"EnableComp","domain":"enablecomp.com","url":"https://alion.io/company/enablecomp","size_band":"501-1000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Lever","truth_index":null},"role":"Finance","role_family":"Finance","seniority":"senior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":80000,"max_usd":152000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":766},"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Office","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-10-02T22:21:08Z","employer_posted_date":"2026-10-02","last_verified_at":"2026-10-14T11:11:07Z","board_verified":true,"closed_at":null,"days_open":11,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":11},"description":"Key Responsibilities\nConducts coding audits of submitted claims to determine appropriateness of procedure and diagnosis codes billed based on documentation provided for both outpatient facility and professional claims.\nReviews Billing for accuracy to ensure compliance of proper billing and coding procedures of third-party carriers and to ensure complete and accurate reimbursement.\nCoordinates with revenue cycle teams to investigate rejected or denied claims to determine denial accuracy and work in an inter-departmental collaboration process to assist in claim corrections/appeals \nEffectively utilizes computer and appropriate software (Microsoft Office Suite) to produce correspondence, charts, spreadsheets and/or other information applicable to the position assignment, including a basic to intermediate level of competency in Excel which is required\nMaintains knowledge regarding medical coding and/or healthcare market changes.\nGather and analyze claims and medical records information pertinent to documentation findings and outcomes; use this information to make educated decisions.\nDraft appeals to payors using nationally sourced coding guidelines such as CPT Assistant, specialty societies, state fee schedule language, AAPC/AHIMA articles etc.\nOther duties as required.\nRequirements and Qualifications\nAssociates or Bachelor’s Degree \nCurrent certification in one of the following: Certified Professional Coder (CPC) or related certification by AAPC, Certified Coding Associate (CCA) by AHIMA, Certified Coding Specialist (CCS) by AHIMA, Registered Health Information Technician (RHIT) by AHIMA.\nThe applicant must have a strong background in orthopedics and surgery billing/coding. The ideal candidate has 5+ years of experience in orthopedic surgery billing, a solid background in coding and medical billing, with special emphasis on AR, EOB's, and overall account management, including coding denials. \nMust be able to gather and analyze claims and medical records information pertinent to documentation findings and outcomes; use this information to make educated decisions.\nMust have strong written communication skills. This position requires the ability to draft grammatically correct well written appeals to payors using nationally sourced coding guidelines such as CPT Assistant, specialty societies, state fee schedule language, AAPC/AHIMA articles etc.\nSound time management skills with the ability to manage workload independently\nStrong analytical, problem solving and research skills with the ability to utilize creative thinking\nMust be comfortable with CAC/Encoder audits and be able to identify appropriate code selection from audit findings.\nEquivalent combination of education and experience will be considered.\nAbility and skill set to work remotely.\nTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions\nMust have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).\nRegular and predictable attendance.\nSpecial Considerations and Prerequisites\nFamiliarity with healthcare documentation systems.\nExperience with multiple fee schedule concepts such as DRGs, APCs, and NCCI.\nStrong verbal, written and interpersonal communication and customer service skills.\nAbility to communicate audit outcomes and testing results with other staff within the company who are both medically and non-medically oriented.\nAbility to interpret policies and procedures and communicate complex topics to others.\nAbility to think critically and make decisions within individual role and responsibility.\nComplex Claims medical billing and coding experience strongly preferred.","description_format":"text","description_chars":3841,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Business Process Outsourcing (BPO)","Revenue Cycle & Medical Billing"],"lifecycle":[{"event":"open","at":"2026-10-03T00:56:51Z"}],"visa":[],"liveness":{"score":77,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":0.9,"age_days":11,"expected_fill_days":20,"reasons":["conf:1","win:mid"],"computed_at":"2026-10-14T06:34:16Z"},"pay":null,"html_url":"https://alion.io/job/enablecomp-coding-denials-auditor","json_url":"https://alion.io/job/enablecomp-coding-denials-auditor.json","meta":{"generated_at":"2026-10-14T12:35:49Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":15447,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-15T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":4046},"rest":"https://alion.io/mcp/rest/get_company?id=4046"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fenablecomp-coding-denials-auditor"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fenablecomp-coding-denials-auditor"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fenablecomp-coding-denials-auditor"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/enablecomp-coding-denials-auditor\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fenablecomp-coding-denials-auditor"}]}