Coding Appeals Specialist – Hospital Billing

Job Overview

The principal purpose of this role is to expedite hospital coding denials to ensure maximum reimbursement and to reduce/eliminate financial loss to department customers. The role involves contacting payers regarding coding issues and using appeal letters to reduce fatal denials. It also includes providing coding expertise to billing teams to assist in proper billing.

Job Responsibilities

• Assists with billing/coding questions from both internal and external customers which include, following up on denials, review of charts and coding issues.
• Backs up for team members within Payroll and all other special assignments from Payroll Director.
• Maintains a close working relationship with all departments and consolidates efforts to ensure appropriate and standardized coding/billing procedures are followed.
• Maintains knowledge of current coding revisions.
• Solves coding issues that arise within the patient accounting departments and provides coding support.
• Works directly with the billing teams to ensure denials for coding are appealed and followed up on appropriately, and in a timely manner.

Working Conditions

• Climbing - Rarely
• Concentrating - Consistently
• Continuous Learning - Consistently
• Hearing: Conversation - Frequently
• Interpersonal Communication - Frequently
• Kneeling - Rarely
• Lifting
• Lifting 50+ Lbs. - Rarely
• Lifting
• Pulling - Rarely
• Pushing - Rarely
• Reaching - Rarely
• Reading - Consistently
• Sitting - Consistently
• Standing - Rarely
• Stooping - Rarely
• Thinking/Reasoning - Consistently
• Using Hands - Frequently
• Color Vision - Consistently
• Walking - Occasionally

Job Requirements

• Associate's Degree in Coding
• RHIT (Associates)
• 3 - 4 years experience in related field
• Billing/Payer knowledge of hospital billing
• Must be familiar and experienced with CDI.
• ICD-9, ICD-10, DRG CPT Coding guidelines
• Medical terminology
• Physiology
• Other Insurance/Certified Pension Consultant (CPC)
• Upon Hire Required
• Other CCS-Certified Coding Specialist
• Upon Hire Required
• Other CMC - Cardiac Medicine-Subspecialty Certification
• Upon Hire Required
• Other CCA - Certified Coding Associate
• Upon Hire Required

Benefits

In addition to a comprehensive benefits package - including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. Please view our benefits page here.