Coding Denial Specialist

Akron Children's Hospital

Full-time, 40 hours/week

Monday-Friday 8am-4:30pm

Remote

Summary:

The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. Working closely alongside the Physician Advisor, the Denial Coding Specialist liaises between the Revenue Recovery team and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. This position reports to the Revenue Recovery Supervisor.

Responsibilities:

Performs retrospective account reviews and resolves coding denials accordingly.
Analyzes coding-related denials (e.g., bundling issues and inappropriate CPT/diagnoses) to identify trends and root causes
Proactively maintains current knowledge of applicable regulations, requirements, changes, and best practices by following industry sources (e.g., Centers for Medicare & Medicaid Services, American Association of Professional Coders, and professional journals)
Reviews EPIC work queues daily for Denial management and makes necessary and appropriate coding changes based on medical documentation for both professional and technical charge revenue.
Follows up with providers to resolve outstanding queries for additional documentation or diagnosis information
Coordinates and/or completes appeals as applicable with payors.
Develops suggestions for coding and documentation process improvements, based on denial analysis and industry coding guidelines
Extracts data into clear reports to revenue recover and revenue cycle leadership, physician advisor, and providers
Partners with Revenue Cycle team leaders, physicians, and providers to develop and implement process improvements
Provides regular feedback and ad-hoc education to revenue recovery staff and providers to promote departmental knowledge of appropriate coding practices
Other duties as required.

Other information:

Technical Expertise

Experience in CPT and ICD coding is required.
Experience working with all levels within an organization is required.
Experience working in an Electronic Medical Record system preferred
Experience in healthcare is preferred.
Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.

Education and Experience

Education: High School Diploma or equivalent is required; Bachelor's degree is preferred.
Certification: AAPC or AHIMA Coding Certification is required.
Years of relevant experience: 0 to 2 years is preferred.
Years of experience supervising: None.

Credentials

Essential (minimum one as applicable):

American Academy of Professional Coders
American Health Information Management Association
Certified Provider Credentialing Specialist
Certified Coding Specialist
Registered Health Information Technician
Certified Coding Associate

Full Time

FTE: 1.000000

Status: Remote

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Vacancy posted 3 days ago

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