Inpatient Coding Denial Specialist

TEKsystems
$25.00 - $30.00 / hr
medical insurance, life insurance, sick time, 401(k), retirement plan
United States, Texas, Waco
Dec 24, 2024
Description Job Summary: 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 Skills Insurance verification, Health care, Medical, Medical billing, Health insurance, medicare, claim, medical terminology, insurance billing, appeals, medical record, medicaid, emr, ehr, medical insurance, revenue cycle, Coding, inpatient coding, medical coder, Icd-10, denials, Cpc, Electronic health record, E&m, epic, cerner, accounts receivable, administrative skills, collection, benefit verification, meditech software Top Skills Details Insurance verification,Health care,Medical,Medical billing,Health insurance,medicare,claim,medical terminology,insurance billing,appeals,medical record,medicaid,emr,ehr,medical insurance,revenue cycle,Coding,inpatient coding,medical coder,Icd-10,denials, Additional Skills & Qualifications BVA: Abstract coding for multiple specialties, denial coding experience as well. Skills and Abilities Needed: Strong knowledge of medical billing and coding practices Extensive knowledge of ICD-10, CPT, HCPCS Strong Insurance Knowledge Ability to work EMR systems Must demonstrate strong analytical skills and proficiency with Microsoft office products Must have strong critical thinking skills Maintains effectiveness when experiencing major changes in work tasks or the work environment Ability to work independently without close supervision Ability to exercise judgement and make decisions Ability to perform in a high productivity, fast-paced environment Interpersonal skills and conflict resolution Attention to detail Excellent phone and computer skills Ability to maintain sensitive information in confidence Ability to meet deadlines and prioritize responsibilities Experience Level Entry Level send resume' to kvanduren @teksystems.com 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 Dec 31, 2024. 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.