Medical Appeals & Coding Specialist
Job Summary
University Medical Billing (UMB) is a fully remote
department that is viewed as the premier billing office for the
University of Utah School of Medicine, serving over 1,800 providers
and 30 different specialties across Utah and surrounding states. We
strive to be a great place to work while providing the best service
to our customers. Our leaders and employees value collaboration,
innovation, and accountability, and believe a successful candidate
will exemplify these attributes too.
We are looking for an experienced
Medical Appeals &
Coding Specialist to join our team. As the Medical Appeals
& Coding Specialist, you will analyze and translate medical and
clinical diagnoses, procedures, injuries, or illnesses into
designated numerical codes. Code records for use and planning by
physicians, hospitals, research organizations, or insurance
companies. Be knowledgeable of medical and clinical terminology,
disease processes, and pharmacology. Complete assignments according
to established guidelines and schedules. May include contact with
patients, families, doctors, or insurance companies. Senior-level
support role. Completes assignments with little supervision. May
assist less-experienced team members. Typically requires 3+ years
of related experience. This is a Skilled Level position in the
Support track.
Employment is contingent on the successful completion of a
background check and the adherence to departmental policies,
including UMB's Telecommuting Agreement which requires a
distraction-free and HIPAA compliant workplace, cameras on for all
virtual calls/meetings, and the ability to work during office hours
or assigned shift (M-F, approximately 8am to 5pm Mountain Time)
regardless of what time zone you live in. Additionally, new hires
are required to provide their own monitors (two) and reliable
internet service.
Compensation & Benefits
The starting salary for this position is
$25-$28 per
hour, depending on experience. Members of UMB are eligible
for a bonus based on department performance. All team members are
eligible for the University's comprehensive benefit package that
includes 90% employer-paid medical insurance, a generous 14.2%
retirement contribution, reduced tuition, PTO and holiday pay, and
more!
Responsibilities
Essential Functions
- Detect abnormalities and provide recommendations for resolution
- Review trends in work queues.
Provide recommendations to supervisory team.
Identify and summarize departmental concerns. Determine,
document and present a summary and suggestion for resolution to
leadership and/or departments.
Identifies, analyzes, and researches frequent root causes of
denials and develops corrective action plans for resolution of
denials working directly with the payers.
Training & Education
- Responsible for providing training, presentations, and
education on billing procedures and workflows, one on one or
in-group settings as needed.
- Reviews specialty work queues for trends for quality coding and
account review and appropriate account resolution of MAC 1 & 2
team members.
Monitor and resolve denials and appeals to ensure timely
collection
- Maintain work queue expectations.
- Evaluate and resolve coding claim rejections and denials
through application of coding concepts, regulatory/policy review
and adherence to internal processes and outbound communication with
insurance companies.
- Compose coding appeal letters and may collaborate with
providers, QA Educators, and other key stakeholders.
Collaborate with leadership team
- Communicate effectively about denial trends affecting insurance
payment.
- Escalate payers outside of turnaround times.
Meet productivity and accuracy expectations of the
position.
Other duties as assigned to support team and department
objectives.
This job description is not designed to contain or be interpreted
as a comprehensive inventory of all duties, responsibilities and
qualifications required of employees assigned to the job.
Minimum Qualifications
EQUIVALENCY STATEMENT: 1 year of higher education
can be substituted for 1 year of directly related work experience
(Example: bachelor's degree = 4 years of directly related work
experience).
Medical Coder, III: Requires 3+ years of related
experience.
Preferences
An especially qualified candidate will also possess the
following:
- High school education or equivalent
- AHIMA or AAPC Certification required
- Minimum 3 years of coding experience or medical billing
- Ability to independently code multi-specialties
- Proven experience working from home effectively
Applicants must demonstrate the potential ability to perform the
essential functions of the job as outlined in the position
description.
Disclaimer
This job description has been designed to indicate the general
nature and level of work performed by employees within this
classification. It is not designed to contain or be interpreted as
a comprehensive inventory of all duties, responsibilities and
qualifications required of employees assigned to the job.
Special Instructions
While UMB is a remote department and this role will be performed
remotely, interested applicants should note the following:
- This role is expected to work during UMB office hours which are
Monday through Friday, 8am to 5pm Mountain Time.
- The University of Utah is committed to providing jobs to
individuals located in Utah, and sees remote roles like this as an
opportunity to provide amazing employment opportunities to those
living in remote areas of the state. As such, Utah-based applicants
may be prioritized in the screening process.
- At this time, the University of Utah is unable to employ
individuals living in California, Colorado, New York, Oregon, or
Washington.
Requisition Number: PRN45959B
Full Time or Part Time? Full Time
Work Schedule Summary: UMB Office Hours; M-F 8:00am to
5:00pm Mountain Time
Department: 00209 - Univ Medical Billing - Oper
Location: Other
Pay Rate Range: $25-$28 per hour
Close Date: 10/15/2026
Open Until Filled:
To apply, visit https://apptrkr.com/9781250"">https://utah.peopleadmin.com/postings/207827
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