Inpatient Coding Appeals & Denials Specialist

Health Business Solutions LLC; Pasig; On-site; PHP 334,800 - 558,000; Full time

Job summary

Health Business Solutions LLC is looking for an IP Coding Appeals Specialist to review inpatient coding denials and prepare appeals. This role plays a crucial part in enhancing reimbursement accuracy and collaborating with coding teams to support claim overturning.

The ideal candidate should have a bachelor's degree in a related field and extensive knowledge of coding systems like ICD-10-CM. Strong analytical skills and experience in handling payer denials are essential for success in this position.

Qualifications

• Minimum 2–4 years of inpatient coding and/or denial appeals experience.
• Strong knowledge of ICD-10-CM and ICD-10-PCS coding systems.
• Familiarity with CMS guidelines and commercial payer policies.

Responsibilities

• Review and analyze inpatient coding denials from payers.
• Prepare and submit detailed, evidence-based appeal letters.
• Collaborate with CDI teams to identify documentation gaps.

Skills

Strong analytical and critical thinking skills

Excellent written communication

Attention to detail and accuracy

Ability to interpret clinical documentation and payer policies

Proficiency in EHR systems and coding/abstracting tools

Education

Bachelor’s degree in Health Information Management, Nursing, or related field

Job description

Health Business Solutions LLC is looking for an IP Coding Appeals Specialist to review inpatient coding denials and prepare appeals. This role plays a crucial part in enhancing reimbursement accuracy and collaborating with coding teams to support claim overturning.

The ideal candidate should have a bachelor's degree in a related field and extensive knowledge of coding systems like ICD-10-CM. Strong analytical skills and experience in handling payer denials are essential for success in this position.