Coding Denial Management Associate

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Coding Denials Management Associate

We are looking for a Coding Denials Management Associate to join the Denials Management team. In this role, the Coding Denials Management Associate will work to apply their coding skills to diagnose and resolve claim denials, rejections, and edits across our network.  This individual will analyze denial trends, identify root causes, and develop workflow improvements to support the performance of our service offering.  The Coding Denials Management Associate will partner closely with Product, Analytics, and Operational teams.  This role reports to the Manager of Service Effectiveness – Denials Management.

The Team: The Denials Management team operates in a dynamic environment where we methodically pursue successful outcomes for our clients.  As part of an expanding operation, you will interact with an array of stakeholders who seek to improve our product, optimize processes and support our clients.  The team is responsible for KPIs related to successful adjudication and increased revenue for athenahealth’s clients.

Job Responsibilities

• Lead detailed claim adjudication analysis to triage rejections, denials, and payer edits; convert adjudication scenarios into consumable, effective processes that identify true root causes and lead to successful outcomes.
• Prepare accurate workflows and procedures: claim corrections, resubmissions, appeals, or configuration updates; partner multiple stakeholders to execute.
• Track denial trends, quantify financial impact, and deliver actionable insights and dashboards to stakeholders. Recommend and validate configuration or workflow changes (mapping, process design and workflow management) that prevent repeat denials.
• Manage multiple remediation projects by urgency/financial impact, and present findings to partners and leadership.
• Proficiency with project management and analytical tools; ability to operate in an agile environment.

Typical Qualifications

• Bachelor’s degree or equivalent professional experience.
• CPC and/or CCS certification (AAPC or AHIMA) is required.
• Bachelor’s degree or equivalent professional experience.
• 3+ years in medical coding with demonstrated experience in claims adjudication, denials, or revenue cycle operations.
• Preferred: Revenue cycle experience working with denials, rules, payer edits, 835/ERA or EOB review, appeals/resubmissions, and claim reprocessing workflows.
• Preferred: Experience using SQL or Sigma to extract data and leverage analytical tools to generate insights and actionable recommendations.

Expected Compensation

The base salary range shown reflects the full range for this role from minimum to maximum. At athenahealth, base pay depends on multiple factors, including job-related experience, relevant knowledge and skills, how your qualifications compare to others in similar roles, and geographical market rates.  Base pay is only one part of our competitive Total Rewards package - depending on role eligibility, we offer both short and long-term incentives by way of an annual discretionary bonus plan, variable compensation plan, and equity plans.

About athenahealth

Our vision: In an industry that becomes more complex by the day, we stand for simplicity. We offer IT solutions and expert services that eliminate the daily hurdles preventing healthcare providers from focusing entirely on their patients — powered by our vision to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Our company culture: Our talented  employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our vision. We are a diverse group of dreamers and do-ers with unique knowledge, expertise, backgrounds, and perspectives. We unite as mission-driven problem-solvers with a deep desire to achieve our vision and make our time here count. Our award-winning culture is built around shared values of inclusiveness, accountability, and support.

Our DEI commitment: Our vision of accessible, high-quality, and sustainable healthcare for all requires addressing the inequities that stand in the way. That's one reason we prioritize diversity, equity, and inclusion in every aspect of our business, from attracting and sustaining a diverse workforce to maintaining an inclusive environment for athenistas, our partners, customers and the communities where we work and serve.

What we can do for you:

Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative  workspaces  — some offices even welcome dogs.

We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. We provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued. 

Learn more about our culture and benefits here: athenahealth.com/careers  

https://www.athenahealth.com/careers/equal-opportunity