- Messages
- 5
- Location
- Acton, MA
Hi all — I'm with Brixa Health, an early-stage company building denial-management and appeal tools for independent rheumatology practices and infusion centers. We're looking for an experienced certified coder for a short paid engagement (roughly 10–20 hours to start, with possible ongoing advisory work) to review our denial logic against how payers actually behave in the real world.
The whole reason for this role is that real payer behavior lives in the heads of people who've worked it — we want your expertise to catch what rules-on-paper miss. Every output in our system is human-reviewed; this is subject-matter-expert work, not production coding, and it isn't here to replace anyone's day job.
What you'd be doing:
Looking for: current CPC (AAPC) or CCS, 3+ years in rheum/infusion or another buy-and-bill specialty, hands-on denials/appeals experience with provider-administered drugs, and fluency reading 835s and CARC/RARC codes. Direct UHC/Aetna/Cigna experience is a big plus. Rate is $60–90/hr depending on experience. Fully remote, flexible hours.
One quick question to answer when you reach out: a UHC commercial claim for infliximab (J1745) comes back denied — what are the two or three most likely reasons you'd expect, and what would you check first? A couple sentences is plenty.
If interested, email me at f.leffler@brixahealth.com with a short note on your background, your certs and years of experience, and your availability.
Thanks!
The whole reason for this role is that real payer behavior lives in the heads of people who've worked it — we want your expertise to catch what rules-on-paper miss. Every output in our system is human-reviewed; this is subject-matter-expert work, not production coding, and it isn't here to replace anyone's day job.
What you'd be doing:
- Sanity-checking our CARC/RARC mappings for medical-benefit biologic denials — which code combinations UHC, Aetna, Cigna, and others actually emit for step-therapy, PA, and benefit-exclusion denials
- Reviewing our appeal-deadline tables for those payers
- Looking at synthetic 835/ERA test files and telling us whether they look like the remittances you've actually worked
- Weighing in on rheum infusion specifics: J-codes for adalimumab/infliximab/abatacept (incl. biosimilars), JW/JZ modifiers, units, common payer edits
Looking for: current CPC (AAPC) or CCS, 3+ years in rheum/infusion or another buy-and-bill specialty, hands-on denials/appeals experience with provider-administered drugs, and fluency reading 835s and CARC/RARC codes. Direct UHC/Aetna/Cigna experience is a big plus. Rate is $60–90/hr depending on experience. Fully remote, flexible hours.
One quick question to answer when you reach out: a UHC commercial claim for infliximab (J1745) comes back denied — what are the two or three most likely reasons you'd expect, and what would you check first? A couple sentences is plenty.
If interested, email me at f.leffler@brixahealth.com with a short note on your background, your certs and years of experience, and your availability.
Thanks!
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