Remote Certified Outpatient Medical Coder & Denial Specialist

Position Type: Full-Time, Contract-to-Hire Location: Remote (Candidates must reside in TN, KY, IN, OH, or VA) Compensation: $18.00 - $26.00 / hour (Depending on experience) Equipment: IT Equipment will be provided by the company

Job Overview

We are seeking a highly skilled, self-motivated Certified Outpatient Medical Coder & Denial Specialist to join a rapidly growing healthcare organization. In this role, you will have the unique opportunity to help rebuild a billing and coding team from the ground up under the guidance of a highly supportive, experienced manager.

This position is ideal for an independent remote worker who thrives in a fast-paced environment, possesses a strict commitment to quality (95% accuracy standard), and has a strong blend of pro-fee outpatient coding and back-end denial management expertise.

Core Responsibilities

• 60% Denial Management & Appeals: * Monitor and work denial queues to identify, track, and analyze trends in denied/rejected claims.

  • Conduct thorough root-cause research (coding errors, missing documentation, payer-specific rules).

  • Navigate payer portals and submit timely, well-documented formal appeals or corrections.

• 40% Medical Coding & Auditing:

  • Review clinical documentation to assign appropriate ICD-10, CPT, and HCPCS codes for outpatient services.

  • Ensure strict compliance with official coding guidelines and payer requirements.

  • Perform internal coding audits and directly query providers when documentation is unclear or insufficient.

Candidate Requirements

• Certification: Active professional coding certification is required (CPC, CCS-P, RHIT, or RHIA). Please note: Apprenticeship certifications (CPC-A or CCA) cannot be considered.

• Experience: Minimum of 2 years of professional, hands-on Pro-Fee outpatient coding experience. (Pure inpatient/facility or DRG validation backgrounds will not align with this role).

• Location/Travel: Must reside in TN, KY, IN, OH, or VA. While this is a remote role, you must be 100% willing and able to commute to a local state clinic for up to one week of face-to-face training if requested.

• Schedule Flexibility: * During Training (First 30–90 days): Must match the Coding Manager’s core day shift hours exactly (Eastern Time Zone).

  • Post-Training: Flexible business hours (e.g., 6:00 AM–2:30 PM, 7:00 AM–3:30 PM, or 8:00 AM–4:30 PM).

Preferred Qualifications

• Proven track record of writing formal, successful insurance appeals.

• Prior experience utilizing CareLogic EHR software.

• Experience coding within behavioral health, substance abuse, or mental health specialties.

Why You’ll Love This Role (Talent Selling Points)

• Massive Growth Potential: Join an organization experiencing explosive growth following a major industry acquisition, giving you immediate exposure to backlogs and high-impact cleanup projects.

• Ground-Floor Opportunity: Help a highly educated, protective, and supportive manager rebuild and shape a high-performing team from the ground up.

• Autonomy: Enjoy the perks of a fully remote role where independent productivity, honesty, and reliable output are highly valued and rewarded.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.