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The Senior Coding Specialist reviews complex denied and underpaid claims to ensure accurate coding and strategic alignment for appeals. They analyze medical records and payer policies to identify coding gaps and recommend corrective actions to improve recovery outcomes.
Candidates must have a CPC certification and at least 3 years of hands-on medical coding experience with proficiency in ICD-10, CPT, and HCPCS. An associate or bachelor's degree is preferred, along with experience in healthcare legal or revenue cycle operations.
Description
Healthcare Legal Solutions is seeking an experienced Senior Coding Specialist to support our end‑to‑end appeals and claims recovery operations. This role will be responsible for ensuring that coding applied to denied and appealed claims is accurate, compliant, and strategically aligned with payer requirements and client expectations. Rather than simply coding high‑volume encounters, this position will focus on reviewing complex claims, interpreting documentation and payer policies, advising on appeal strategy, and supporting quality and consistency across our coding and denial management workflows.
The Senior Coding Specialist will have visibility across multiple product lines and venues, including inpatient and outpatient hospital claims, professional services, and specialty service lines, as applicable to client engagements. They will help operationalize coding guidelines, regulatory requirements, and client policies; identify coding‑related denial trends; recommend corrective actions; and contribute to process improvements that enhance both recovery outcomes and compliance. This role may also provide guidance and education to internal staff and client teams on documentation standards, coding changes, and payer expectations.
Key Responsibilities
Qualifications
Fast learners with solid foundational experience in coding, denials, or healthcare operations are encouraged to apply.
HLS submits appeals for denied, complex, and underpaid hospital claims so providers can maximize reimbursement.
Healthcare Legal Solutions, LLC, (“HLS”) is a legal collections firm specializing in third party payer collections for hospitals and health systems. We resolve third party problematic -- delayed, denied or underpaid -- claims from payers such as Medicare, Medicaid, MCOs, Commercial, Blue Cross, employers groups with ERISA plans and others. We set up appeals and intensive follow-up programs to supplement the efforts of hospital revenue cycle and case management departments. HLS specializes in the collection of older receivables which may require a specialized legal skillset. This specialization translates in superior collections from 30-60% of net additional revenue over in-house and industry standard bad-debt processes.
Offices: 2001 Pennsylvania Avenue, NW, Suite 750, Washington, DC 20006, US
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