Acute Coding Appeals Specialist
Core
Review and write appeals for inpatient Diagnosis Related Group (DRG) denials to support assigned codes and address clinical documentation validity.
Role type
Acute Coding Appeals Specialist
Builds
Substantiated coding principles and billing/coding issue resolutions for health systems.
Domain
Healthcare revenue cycle management / Medical coding
Required skills
ICD10CM, ICD10PCS, HCPCS, NCCI, CMS, CMG coding expertise, inpatient facility coding, appeals and denials management, regulatory standards knowledge, clinical documentation review
Preferred skills
AI process exploration, client system education, root cause analysis
Technologies
Medical coding and billing systems
Responsibilities
Review and write appeals for inpatient DRG denials; Participate in client system education to ensure coding is supported by clinical documentation; Maintain meticulous documentation and search regulatory rules to identify billing requirements; Assist in education and training for client coding companions; Meet established productivity standards for coding appeals
Seniority
Mid-level, hands-on IC
