HCA Healthcare
Inpatient Coding Denial Specialist
HCA Healthcare, Nashville, Tennessee, United States,
Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting opportunity for you to join Work from Home which is part of the nation's leading provider of healthcare services, HCA Healthcare.Our teams are a committed, caring group of colleagues. Do you want to work as an Inpatient Coding Denial Specialist where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!Job Summary and Qualifications
The Inpatient Coding Denials Specialist is a high-level coding expert responsible for investigating and resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain root cause of denials.What you will do in this role:
Analyzes documentation to support codes/DRGs and abstracted data (e.g., discharge disposition) for inpatient records for multiple facilities using ICD-10- CM and ICD-10-PCS to include:Principal diagnosis code assignmentSecondary diagnosis code assignmentProcedure code assignmentIdentifies and writes clear and concise appeal letters utilizing all available documentation, regulations and guidelines to defend the billed claimUtilize the following resources to identify the root cause of the denial/downgradeExplanation of Benefits/Remittance AdviceComplex NCD/LCD guidelines, CMS/AHCA policies and regulationsFederal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug Administration, Medicare Administrative Contractors and payer websitesEscalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunitiesMaintains or exceeds established productivity standardsMaintains or exceeds established accuracy standardsAs needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) or Coding Account Resolution Specialist III (CARS-III) dutiesReviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain currentFollows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes/DRGsMeets all educational requirements as stated in current Company and HSC policyPractice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”Other duties as assignedQualifications:
High School graduate or GED equivalent preferred, undergraduate (associate or bachelors) degree in HIM/HIT preferred.Minimum 3 years of acute care hospital inpatient coding required, 5 years preferred.Experience working payer denials and/or coding auditing preferred.RHIA, RHIT or CCS preferred.If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Coding Denial Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
Unlock the possibilities and apply today!We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
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The Inpatient Coding Denials Specialist is a high-level coding expert responsible for investigating and resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain root cause of denials.What you will do in this role:
Analyzes documentation to support codes/DRGs and abstracted data (e.g., discharge disposition) for inpatient records for multiple facilities using ICD-10- CM and ICD-10-PCS to include:Principal diagnosis code assignmentSecondary diagnosis code assignmentProcedure code assignmentIdentifies and writes clear and concise appeal letters utilizing all available documentation, regulations and guidelines to defend the billed claimUtilize the following resources to identify the root cause of the denial/downgradeExplanation of Benefits/Remittance AdviceComplex NCD/LCD guidelines, CMS/AHCA policies and regulationsFederal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug Administration, Medicare Administrative Contractors and payer websitesEscalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunitiesMaintains or exceeds established productivity standardsMaintains or exceeds established accuracy standardsAs needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) or Coding Account Resolution Specialist III (CARS-III) dutiesReviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain currentFollows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes/DRGsMeets all educational requirements as stated in current Company and HSC policyPractice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”Other duties as assignedQualifications:
High School graduate or GED equivalent preferred, undergraduate (associate or bachelors) degree in HIM/HIT preferred.Minimum 3 years of acute care hospital inpatient coding required, 5 years preferred.Experience working payer denials and/or coding auditing preferred.RHIA, RHIT or CCS preferred.If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Coding Denial Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews.
Unlock the possibilities and apply today!We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
#J-18808-Ljbffr