Clinical Coding Appeals Supervisor

R1 RCM; United States; Remote; USD 84,000 - 140,000; Full time

Job summary

Join a forward-thinking company as a Clinical Coding Appeals Supervisor, where you will lead a team of clinical coders in enhancing the patient experience and financial performance of healthcare systems. This role is pivotal in managing coding denials, formulating appeals, and ensuring quality metrics are met. You will collaborate with non-coding staff and attorneys, perform audits, and contribute to a culture of continuous learning and improvement. If you are passionate about making a difference in healthcare and possess the required coding certifications and leadership experience, this opportunity is perfect for you.

Benefits

Competitive benefits package

Annual bonus plan

Opportunities for career growth

Collaborative work environment

Qualifications

• Prior leadership experience in medical record reviews is essential.
• Extensive knowledge of medical coding for inpatient and outpatient claims.

Responsibilities

• Supervise day-to-day operations and ensure productivity metrics are met.
• Audit appeals and provide feedback to team members regularly.
• Coordinate assignments to meet productivity and quality goals.

Skills

Leadership in medical record reviews

Medical coding knowledge

Registered Nurse license

AHIMA or AAPC Coding Certification

Job description

R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical groups. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration.

As our Clinical Coding Appeals Supervisor, you will support clinical coders and coding team members who conduct a comprehensive review of coding denials and formulate appeals based on documentation and/or make coding change suggestions for corrected claims as appropriate. Every day you will supervise the day-to-day operations and functions within the department, ensuring productivity and quality metrics are met, and manage coding team personnel and provide feedback on performance. To thrive in this role, you must have prior leadership experience in medical record reviews and extensive knowledge of medical coding for inpatient and outpatient claims, as well as reimbursement guidelines.

Here’s what you will experience working as a Clinical Coding Appeals Supervisor:

• Track daily inventory of cases and coordinate assignments to coding team to ensure cases worked in a manner to meet productivity and quality goals.
• Track, evaluate, and report overturned appeals.
• Audit a sample of appeals weekly to provide feedback regarding strategy and effective appeal writing.
• Review cases for viability for escalation, as well as final determination of no appeals/unsupportable designation.
• Review overturns to adjust practice and provide feedback to coders.
• Maintain and update payor policies.
• Act as point of contact for non-coding staff and attorneys to collaborate on appeals processing.
• Perform performance evaluations of team members and 1:1 meetings on a routine basis.

Required Skills:

• Active Registered Nurse license
• Active AHIMA or AAPC Coding Certification including CCS, RHIA, RHIT, CCA, CPC-A, CPC-H (COC), CPMA, or CIC

For this US-based position, the base pay range is $84,456.00 - $139,823.91 per year. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a target of 10.00%.

The healthcare system is always evolving — and it’s up to us to use our shared expertise to find new solutions that can keep up. On our growing team you’ll find the opportunity to constantly learn, collaborate across groups and explore new paths for your career.

Our associates are given the chance to contribute, think boldly and create meaningful work that makes a difference in the communities we serve around the world. We go beyond expectations in everything we do. Not only does that drive customer success and improve patient care, but that same enthusiasm is applied to giving back to the community and taking care of our team — including offering a competitive benefits package.

R1 RCM Inc. (“the Company”) is dedicated to the fundamentals of equal employment opportunity. The Company’s employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, the Company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories.

If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance.

CA PRIVACY NOTICE: California resident job applicants can learn more about their privacy rights California Consent.

To learn more, visit: R1RCM.com.

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