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Lakeshore Talent is in search of a Certified Coding Appeals Specialist to join our client’s team on a short-term contract basis. This position offers an excellent opportunity to contribute to a mission-driven healthcare organization by supporting accurate coding, compliance, and revenue recovery efforts.
Position Details
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Type: Contract (1 Month)
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Pay Rate: $31.00 – $35.00 per hour
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Schedule: Monday – Friday, 8:00 AM – 5:00 PM
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Location: Denver, CO
Position Summary
The Certified Coding Appeals Specialist is responsible for reviewing denied medical claims, identifying coding-related issues, and preparing accurate, timely appeals to payers. This role ensures compliance with coding standards and supports revenue recovery through detailed documentation and collaboration with clinical and billing teams.
Essential Functions and Work Responsibilities
Claims Review & Appeals
- Analyze denied claims to determine root causes related to coding, documentation, or payer policy.
- Utilize SharePoint to review and submit claims
- Prepare and submit appeal letters with supporting documentation and coding rationale.
- Track and report on appeal outcomes, escalating complex denials when necessary.
Coding Accuracy
- Review medical records to ensure proper ICD-10, CPT, and HCPCS code assignment.
- Validate coding against CMS guidelines and PACE-specific billing requirements.
- Collaborate with providers to clarify documentation and ensure coding integrity.
Compliance & Documentation
- Maintain current knowledge of coding regulations, payer policies, and CMS requirements.
- Ensure all appeal activities comply with HIPAA and internal audit standards.
- Accurately document appeal activity and outcomes in the billing system or EMR.
Collaboration & Reporting
- Partner with billing, clinical, and compliance teams to resolve coding-related denials.
- Provide feedback and education on denial trends and prevention strategies.
- Generate and analyze reports on appeal volumes, success rates, and financial impact.
Qualifications
Required:
- High school diploma or equivalent.
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent credential.
- Minimum 2 years of experience in medical coding and appeals
- Strong understanding of payer guidelines, medical terminology, and healthcare reimbursement.
- Proficiency in SharePoint
- Knowledge of geriatric care, interdisciplinary documentation, and CMS billing rules.
- Proficiency in EMR systems and billing software.
Preferred:
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Experience with Medicare, Medicaid, and commercial payer appeals.
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Familiarity with risk adjustment, HCC coding, or specialty-specific coding (oncology, cardiology, etc.).
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Excellent written communication, analytical, and organizational skills.
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Strong attention to detail and ability to work independently.
To perform this job successfully, an individual must be able to carry out each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.