Managed end-to-end insurance denials, appeals, and claim reprocessing using Athenahealth Revenue Cycle Management platform. Investigated denials related to ICD-10-CM, CPT, HCPCS, authorization, and medical necessity requirements. Reviewed EOBS, ERAs, and clinical documentation to support payment recovery and claim resolution. Collaborated with providers, coders, and billing teams to resolve complex denial cases. Monitored denial trends and implemented corrective actions to improve reimbursement outcomes.

Assigned ICD-10-CM, CPT and HCPCS Level II codes for inpatient and outpatient encounters. Reviewed physician documentation, laboratory reports, pathology reports and diagnostic findings. Applied medical terminology, anatomy, physiology, DRG methodology and reimbursement principles. Conducted clinical documentation reviews and identified coding discrepancies. Achieved 98% coding quality and 97% audit compliance.