Health Business Solutions LLC

Summary: 

Revenue Cycle Denials/ Clinical Coding Quality Auditor identifies training opportunities, and supports continuous quality improvement across the denials team. 

Key Responsibilities: 

• Perform routine audits of denial work, including root cause identification, appeal accuracy, and documentation quality 

• Validate compliance with payer guidelines and internal workflows 

• Provide clear, constructive feedback and assist with training needs 

• Track quality trends and support process improvement initiatives 

• Review Epic account documentation to ensure correct handling and resolution 

Qualifications: 

• 2+ years of experience in revenue cycle, denials, coding, billing, or insurance follow‑up 

• Coding experience (CPC/CCS a plus) 

• Clinical nursing experience 

• Epic experience preferred 

• Strong knowledge of payer rules, denials, and appeal processes

• Detail‑oriented with excellent communication and analytical skills 

Preferred Skills: 

• Experience performing quality audits 

• Understanding of medical terminology and coding concepts