Medical Coder – Resubmissions

About the role

The Medical Coder – Resubmissions ensures denied, rejected, or unpaid insurance claims are accurately corrected and resubmitted, supporting timely reimbursement and revenue integrity.

Key responsibilities

• Review denied, rejected, and unpaid claims to identify root causes and determine corrective actions.
• Analyze medical records, coding, and billing information for accuracy and payer compliance.
• Correct coding, demographic, authorization, eligibility, and billing errors before resubmission.
• Resubmit claims within payer-defined timelines and monitor their status.
• Prepare and submit appeal requests with appropriate documentation.
• Generate reports on denial trends, resubmission volumes, and recovery rates.

Required profile

• Bachelor's degree in Health Information Management, Medical Records, Healthcare Administration, Nursing, Pharmacy, or related field.
• Professional coding certification such as CPC (Certified Professional Coder).
• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.

Required skills

• ICD-10-CM coding
• CPT coding
• HCPCS coding
• Claim denial analysis
• Resubmission and appeals processing