Acute Coding Appeals Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• The appeals specialist applies medical coding principles and impartiality in executing coding appeals and denial activities.

• Utilizes expertise in ICD10CM, ICD10PCS, HCPCS, NCCI, CMS, and CMG coding to identify potential billing and coding issues, as well as quality concerns.

• Engages in client system education to acquire the necessary knowledge for appealing client accounts.

• Maintains thorough documentation, spreadsheets, and examples of accounts and claims that highlight root cause issues.

• Conducts research on governmental, payor-specific, hospital-specific, regulatory body, and literature rules and regulations to pinpoint requirements and provide recommendations to clients.

• Aids in the education and training of client coding companions.

• Achieves set productivity standards for coding appeals and meets coding certification requirements.

• Delivers outstanding customer service in a well-organized and efficient manner while upholding a positive attitude.

⛳️ Requirements

• Prior experience in inpatient facility coding, including work with appeals, denials, and edits.

• A minimum of 5 years of experience in coding is required.

• In-depth knowledge of medical coding and billing systems, along with documentation and regulatory requirements.

• Must be curious and show a willingness to embrace innovation, including the use of AI, to discover improved processes and enhance patient and client experiences.

🏝️ Benefits

• Bonus Incentives

• Paid Certifications

• Tuition Reimbursement

• Comprehensive Benefits

• Career Advancement