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EnableComp provides healthcare revenue cycle management services for providers and health systems across the United States. Its work centers on complex claims involving Veterans Administration, Workers’ Compensation, motor vehicle accidents, and out-of-state Medicaid, along with denial management across payer classes. Using intelligent automation and its proprietary E360 RCM™ platform, EnableComp supports more efficient billing, accurate reimbursement, and stronger collections. For job seekers, the company’s profile is most relevant to roles connected to healthcare operations, claims, revenue cycle management, billing technology, and client services.
Coding Denials Auditor — Tennessee Remote
Audit outpatient facility and professional claims for coding accuracy, billing compliance, and denial resolution at EnableComp. Prepare payer appeals and analyze medical records using established coding guidelines.
Description
- Audit submitted outpatient facility and professional claims for coding accuracy.
- Evaluate billing accuracy and compliance with third-party carrier coding and billing procedures.
- Work with revenue cycle teams to investigate rejected and denied claims.
- Support claim corrections and appeals through cross-functional collaboration.
- Use Microsoft Office to prepare correspondence, charts, spreadsheets, and related materials.
- Keep current with medical coding practices and changes across the healthcare market.
- Analyze claims and medical records to evaluate documentation findings and outcomes.
- Prepare payer appeals based on nationally recognized coding guidelines.
- Share coding expertise and audit findings with internal and external stakeholders.
- Complete additional duties as assigned.
Requirements
- Associate or bachelor's degree.
- Current CPC, AAPC-related, CCA, CCS, or RHIT certification.
- Strong experience with orthopedic and surgical billing and coding.
- Five or more years of orthopedic surgery billing experience preferred.
- Experience in coding and medical billing, including accounts receivable, EOBs, account management, and coding denials.
- Ability to collect and analyze claims and medical-record information.
- Strong written communication skills.
- Ability to write grammatically accurate appeals using CPT Assistant, specialty-society guidance, state fee schedules, and AAPC or AHIMA articles.
- Effective time management and the ability to manage work independently.
- Strong analytical, problem-solving, research, and creative-thinking abilities.
- Comfort conducting CAC or Encoder audits and determining appropriate code selection.
- Equivalent combinations of education and experience will be considered.
- Ability to work remotely.
- Proficiency with Microsoft Word, Excel, and Outlook.
- Regular and dependable attendance.
- Familiarity with healthcare documentation systems.
- Knowledge of DRGs, APCs, and NCCI fee schedule concepts.
- Strong verbal, written, interpersonal, and customer service communication skills.
- Ability to explain audit findings and testing results to clinical and nonclinical staff.
- Ability to interpret policies and procedures and explain complex topics clearly.
- Critical-thinking skills and sound decision-making within assigned responsibilities.
- Complex Claims medical billing and coding experience strongly preferred.
Benefits
- Opportunities for professional growth and development.
- Career-development tools, resources, and support.
- Flexible, family-oriented workplace culture.
- Support for maintaining work-life balance.
- Remote work option.
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