Coding Audit & Appeals Specialist: Reimbursement Optimizer

TriHealth; Norwood (OH); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement plans

Tuition reimbursement

Job summary

TriHealth in Cincinnati/Norwood is seeking a Coding Audit & Appeals Specialist to protect revenue by resolving denials and crafting effective appeals. You will apply ICD-9/ICD-10, DRG, CPT, and CDI expertise to ensure accurate, compliant coding and hospital billing.

You’ll collaborate with billing teams and internal partners, stay current on coding guidelines, and contribute to a culture of accuracy, compliance, and service excellence within TriHealth.

Qualifications

• Associate's Degree in Coding RHIT (Required).
• 3–4 years experience in related field.
• Billing/Payer knowledge of hospital billing.
• Familiar with CDI, ICD-9/ICD-10, DRG.
• Knowledge of CPT coding guidelines.
• Medical terminology and physiology knowledge.
• CPC/CCS/CMC/CCA certifications required on hire.

Responsibilities

• Assist with denials follow-up and chart reviews for coding issues.
• Back up team members and support Payroll-related tasks when needed.
• Ensure compliance with coding rules from government and payers.
• Maintain standardized coding/billing procedures across departments.
• Stay current with coding revisions and provide denials resolution.
• Collaborate with billing teams to appeal denials and track outcomes.

Skills

ICD-9/ICD-10 knowledge

DRG understanding

CPT coding knowledge

Medical terminology

Physiology

Payer/billing review

Education

RHIT degree or equivalent

CPC Certification

CCS Certification

CMC Certification

CCA Certification

Job description

TriHealth in Cincinnati/Norwood is seeking a Coding Audit & Appeals Specialist to protect revenue by resolving denials and crafting effective appeals. You will apply ICD-9/ICD-10, DRG, CPT, and CDI expertise to ensure accurate, compliant coding and hospital billing.

You’ll collaborate with billing teams and internal partners, stay current on coding guidelines, and contribute to a culture of accuracy, compliance, and service excellence within TriHealth.