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 supporting denial prevention efforts. This role reviews inpatient records, validates documentation, prepares appeal letters, and works across multiple facilities to ensure accurate coding, DRG assignment, and timely account resolution.
Key duties include:
- Analyze documentation to support codes and DRGs for inpatient records
- Assign principal, secondary, and procedure codes using ICD-10-CM and ICD-10-PCS
- Determine discharge disposition and review abstracted data
- Write clear and concise appeal letters using documentation, regulations, and guidelines
- Research denial causes using payer correspondence, CMS guidance, and other authoritative resources
- Escalate trends and problematic accounts to support denial prevention and coding education
- Maintain productivity, accuracy, and compliance with company and regulatory standards
Requirements & Qualifications
- High school diploma or GED preferred
- Associate or bachelor’s degree in HIM/HIT preferred
- Minimum 3 years of acute care hospital inpatient coding experience required; 5 years preferred
- Experience with payer denials and/or coding auditing preferred
- RHIA, RHIT, or CCS preferred
- Strong knowledge of ICD-10-CM and ICD-10-PCS coding
- Ability to review documentation, identify denial root causes, and prepare appeals
- Strong critical thinking, accuracy, and productivity skills
Benefits & Perks
- Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine coverage
- Free counseling and referral services
- Paid time off, paid family leave, disability coverage, and leaves of absence
- 401(k) plan with 100% match on 3% to 9% of pay based on years of service
- Employee Stock Purchase Plan
- Flexible spending accounts
- Preferred banking partnerships and retirement readiness tools
- Tuition assistance, student loan assistance, certification support, and dependent scholarships
- Fertility and family building support, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection, and consumer discounts
Location
Nashville, Tennessee, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago