Senior Coding & Denials Specialist

Metro Vein Centers is a rapidly growing healthcare practice specializing in state-of-the-art vein treatments. Our board-certified physicians and expert staff are on a mission to improve peoples quality of life by relieving the painful yet highly treatable symptoms of vein diseasesuch as varicose veins and heavy aching legs.

With over 70 clinics across 8 states and still growingwere building the future of vein caredelivering compassionate results-driven care in a modern patient-first environment.

We proudly maintain a Net Promoter Score (NPS) of 93 the highest patient satisfaction in the industry.

Position Overview: The Senior Coding & Denials Specialist is a subject matter expert responsible for investigating resolving and preventing coding- and billing-related claim denials.

This position combines advanced medical coding knowledge with strong revenue-cycle payer-policy claims and appeals expertise. The Senior Coding & Denials Specialist will analyze denied and underpaid claims determine the root cause research applicable coding and payer requirements develop and submit appropriate appeals or corrected claims and work collaboratively with Coding Billing Clinical Operations and providers to prevent recurring denials.

The ideal candidate is a critical thinker and problem solver who can move beyond simply resolving an individual denial to identifying why the denial occurred what process contributed to it and what needs to change to prevent it from happening again.

Key Responsibilities:

• Review patient records and accurately assign appropriate ICD-10-CM CPT and HCPCS codes for diagnoses procedures and treatments
• Apply advanced knowledge of ICD-10-CM CPT and HCPCS coding to investigate coding-related denials
• Review medical records and clinical documentation to determine whether the documentation supports billed services
• Identify coding modifier bundling medical necessity documentation authorization and claim-submission issues contributing to denials
• Research CMS requirements NCCI edits MUEs Medicare and Medicaid requirements and commercial payer policies as applicable
• Evaluate payer-specific reimbursement policies and determine the appropriate claim resolution strategy
• Provide coding guidance for complex claims and denial scenarios
• Collaborate with providers and clinical staff when additional documentation or clarification is required
• Maintain up-to-date knowledge of coding standards medical terminology relevant regulatory requirements and internal MVC policies

Minimum Qualifications:

• Advanced knowledge of ICD-10 CPT and HCPCS coding systems medical terminology anatomy and physiology and healthcare CMS/payer specific documentation requirements
• Strong understanding of Medicare Medicaid and commercial payer requirements
• Demonstrated experience researching and resolving medical claims denials
• Demonstrated experience preparing and submitting claim appeals and/or reconsiderations
• Strong understanding of EOBs/ERAs claim adjustments corrected claims and payer correspondence
• Strong analytical investigative and problem-solving skills
• Demonstrated computer literacy and ability to efficiently navigate Electronic Medical Records (EMR) systems
• Ability to work independently unsupervised and manage time appropriately
• Excellent verbal and written communication abilities

Required Certifications and Experience

• Certified Professional Coder (CPC) Certified Coding Specialist (CCS) Registered Health Information Technician (RHIT) or equivalent certification required
• Minimum of four years of medical coding experience (multispecialty or vascular coding preferred)
• Minimum of 2 years of hands-on denial management claims resolution and/or appeals experience preferred
• Successfully complete and pass a coding assessment
• Previous experience with GE Centricity/Athena EMR preferred

Preferred Qualifications

• Vascular vein interventional radiology surgery or other procedural specialty experience
• Experience with medical necessity authorization and documentation-related denials
• Experience performing denial trend analysis and root-cause analysis
• Experience developing denial-prevention strategies
• Experience communicating with payer representatives
• Experience with claims analytics and revenue-cycle reporting
• Advanced Excel skills including pivot tables filtering lookups and data analysis

Full-time team members at Metro Vein Centers are eligible for:

• Medical Dental and Vision Insurance
• 401(k) with Company Match
• Paid Time Off (PTO) Paid Company Holidays
• Company-Paid Life Insurance
• Short-Term Disability Insurance
• Employee Assistance Program (EAP)
• Career Growth & Development Opportunities

The Metro Vein Centers Difference

Healthy legs. Happier lives.
At Metro Vein Centers we believe exceptional care begins with an exceptional experience. Our mission is to make vein care approachable empowering and connected to overall well-being. From the first conversation to the final follow-up every patient interaction reflects our commitment to compassion expertise and trust.

A team united by purpose.
Our values guide everything we do:

• Patients First Always Every interaction should make our patients feel valued heard and cared for.
• Stronger Together Teamwork and collaboration drive our success. We lift each other up to deliver the best for our patients.
• A Can-Do Spirit We meet every challenge with positivity flexibility and problem-solving energy.
• Results That Make a Difference Were driven to improve lives through meaningful measurable outcomes.
• Commitment to Growth We invest in our people fostering advancement and professional development at every level.

Metro Vein Centers is an Equal Opportunity Employer.
Were committed to creating a workplace where everyone feels seen heard and supported. We do not discriminate based on race color religion sex national origin age disability genetics gender identity or expression sexual orientation veteran status or any other protected status in accordance with applicable federal state and local laws. This policy applies to all aspects of employment including recruitment hiring promotion compensation benefits and termination.

Legal & Compliance Notice:
Metro Vein Centers complies with all applicable federal state and local employment laws including those related to nondiscrimination equal opportunity and pay transparency. Where specific disclosures or postings are required by law we provide this information as part of our hiring process or upon request.

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