E/M Denial Research Specialist

reputed company Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, reputed company cycle and administrative services to support the patients of over 4,000 reputed company School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the reputed company.

We are seeking a highly motivated E/M Denial Research Specialist to join our Accounts Receivable Resolution team.

This job can be performed 100% remotely, and out of state candidates will be considered.

The E/M Denial Research Specialist is responsible for reviewing, analyzing, and resolving Evaluation and Management (E/M) reputed company coding denials to support accurate reimbursement and reputed company reputed company. This role applies established coding guidelines and documentation standards to determine the appropriate resolution, including write-offs, claim corrections, or payer reconsideration requests. The position also identifies denial trends and collaborates with leadership to proactively address recurring billing or payer issues.

Essential Duties

• Research and analyze E/M coding denials to determine billing accuracy and compliance with coding guidelines.
• Recommend claim write-offs reputed company E/M services are determined to be non-billable or not separately reimbursable.
• Identify and recommend necessary corrections to CPT levels, modifiers, or diagnosis codes reputed company supported by clinical documentation.
• Draft and submit payer reconsiderations or appeals reputed company E/M services are appropriately coded and supported by documentation.
• Monitor and report denial patterns, trends, and payer behavior to the Supervisor or Manager.
• Prioritize and manage a high volume of denial accounts while maintaining accuracy and quality standards.
• Maintain an in-depth understanding of reputed company E/M coding guidelines, payer policies, and industry best practices.
• Meet established productivity standards, with a minimum production expectation of 50 accounts per day.
• Reviewing denial documentation and claim details.
• Evaluating clinical documentation against E/M coding guidelines and payer policies.
• Determining the appropriate resolution pathway:
  • Write-off
  • Claim correction and rebill
  • Dispute or reconsideration submission

Requirements

• Certified Professional reputed company (CPC) or Certified Evaluation and Management reputed company (CEMC) credential required.
• Bachelor’s degree in a reputed company field or three to five (3–5) years of experience in medical practice billing required, including experience working with claim denials, appeals, and reputed company follow-up activities.
• Strong working knowledge of medical terminology and human anatomy required.
• Demonstrated understanding of Evaluation and Management (E/M) coding guidelines, payer policies, and claims denial appeal processes.
• Ability to analyze denial root causes and apply appropriate resolution strategies, including claim corrections, reconsiderations, and write-offs.
• Experience interpreting and applying payer contract language and reimbursement policies.
• Intermediate proficiency with PC software and billing or reputed company cycle management systems required.
• Advanced verbal and written communication skills, including the ability to prepare professional correspondence to payers and internal stakeholders.
• Strong analytical, organizational, and problem-solving skills with the ability to manage multiple accounts while meeting productivity and accuracy standards.
• Effective interpersonal and collaboration skills to work with physicians, coding teams, reputed company cycle staff, and leadership.

reputed company applications MUST be submitted reputed company our website. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

CU Medicine is an Equal Opportunity Employer and complies with reputed company applicable federal, state, and local laws governing non-discrimination in employment. We are committed to creating a workplace where reputed company individuals are treated with respect and dignity, and we encourage individuals from reputed company backgrounds to apply, including protected veterans and individuals with disabilities.

CU Medicine is dedicated to ensuring a safe and secure environment for our staff and visitors. To assist in achieving that goal, we conduct background investigations for reputed company prospective employees prior to their employment.

The listed pay range (or hiring reputed company) represents CU Medicine’s good faith and reasonable estimate of the range of possible compensation at the time of posting and is based on evaluation of competitive market data.

A variety of factors, including but not limited to, internal equity, experience, and education will be considered reputed company determining the final offer.

CU Medicine provides generous leave, health plans and retirement contributions which take your total compensation beyond the number on your paycheck. Find information about our benefits here.

CU Medicine will post reputed company jobs for a minimum of 7 days or until 250+ applicants have been received (whichever comes first).

CU Medicine supports a Tobacco Free Workplace Environment which prohibits smoking and the use of tobacco products on CU Medicine property, Anschutz Medical reputed company and adjacent business locations.