Coding Denial Analyst - Hospital Inpatient (1.0)

Franciscan Alliance, Inc.

2d•$51,002 - $75,868•Remote

About The Position

The Hospital Inpatient Coding Analyst is responsible for addressing coding related denials across Franciscan Alliance. Additionally, the Coding Denial Analyst monitors denial results and notifies Coding Leadership of any identified trends.

Requirements

High School Diploma/GED - Required
3 years Coding - Required
Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required

Nice To Haves

Associate's or Bachelor's Degree for Health Information Management - Preferred
1 year Coding Denials/Payer Experience - Preferred
Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Preferred
Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Preferred

Responsibilities

Develops and submits well-supported appeal letters related to coding denials utilizing excellent written and communication skills.
Reviews, researches, and responds to inquiries, denial management, and follow-up questions, according to Coding Department approved resources.
Reviews and processes claims and edits for accuracy and insurance and coding compliance.
Utilizes official coding guidelines and follows established policies and procedures, to determine accurate code selection based upon documentation in the medical record.
Acts as a subject matter expert for coding, billing and payer edits and denials.
Assesses and ranks denials priority to align with Rev Cycle goals.
Assesses denial and takes action to adjust claim data and resubmit corrected claim, prepare and coordinate appeal response, and prepare avoidable write off documentation.
Collaborates with coding leadership, to improve key performance indicators through trending denials.
Coordinates timely response to denials, reaching out to other Franciscan Alliance departments, as well as payers when necessary through denial resolution.
Recommends improvements/adjustments to workflow and system build in response to changes in reimbursement methodology, coding guidelines, regulatory standards, or department workflow changes to prevent denials.