Inpatient Coding Denial Specialist

TEKsystems
$25.00 - $30.00 / hr
life insurance, sick time, 401(k), retirement plan
United States, Texas, Waco
Jan 07, 2025
Location: * Fully remote. Equipment will be provided. Hours: * 8am-5pm CST M-F Description 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 serves as an internal auditor and educates on findings to ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain root cause of denials. Job Duties: * Accurately and efficiently audits and analyzes medical records, charge sheets and reports to ensure in the coordination of proper coding/billing. * Analyzes documentation in our work que 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 * Identifies and writes clear and concise appeal letters utilizing all available documentation, regulations and guidelines to defend the billed claim * Utilize the following resources to identify the root cause of the denial/downgrade * Explanation of Benefits/Remittance Advice * Payer denial/DRG downgrade letters * Complex NCD/LCD guidelines, CMS/AHCA policies and regulations * Supports the integrity of the coding and accurate reimbursement, quality scores, benchmark data and statistical reporting. * Escalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunities * Maintains or exceeds established productivity standards * Maintains or exceeds established accuracy standards Additional Skills & Qualifications * Minimum 3 years of hospital inpatient coding experience * Minimum of 2 years of experience working payer denials and/or coding auditing * Must have an actively certified coder. (AHIMA, AAPC; RHIA, RHIT, CPC, CCS) * Must also be knowledgeable & experienced within ICD-10-CM, PCSCPT & HCPCS codes * Software Experience Needed: Meditech, 3M, Cerner &/or EPIC Pay and Benefits The pay range for this position is $25.00 - $30.00 * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This is a fully remote position. Application Deadline This position will be accepting applications until Jan 21, 2025. About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.