HIM DRG Denial Coordinator

CCMC Cook Children's Medical Center; Texas; Hybrid; USD 65,000 - 90,000; Full time

Job summary

Cook Children’s Medical Center is seeking a DRG Denials Coordinator in the HIM-Coding department to manage and streamline DRG denials communications. You will review denial letters from third-party payors, analyze and abstract data into the correct fields, and identify root causes and financial impact.

You will present payer denials to Physician Advisors and the CDI Director for review, applying inpatient coding knowledge (ICD-10-CM/PCS) and regulatory compliance requirements to support accurate

Qualifications

• Three years inpatient coding experience with ICD-10-CM/PCS required.
• In lieu of education requirements, 5 years of acute care or 5 years inpatient coding experience required.
• Must have strong knowledge of Coding regulations and regulatory compliance experience.

Responsibilities

• Manage and maintain DRG Denials correspondence.
• Review and organize denial letters by third-party payor, analyze and abstract data into proper fields.
• Identify root cause and financial impact; present payer denials to Physician Advisors and CDI Director for review.

Skills

Inpatient coding

ICD-10-CM/PCS

Regulatory compliance

Education

Associates degree in HIM, Business or related field

Job description

Location

Remote - TX

Department

HIM-Coding

Shift

First Shift (United States of America)

Standard Weekly Hours

20

Summary

The DRG Denials Coordinator is responsible for managing and maintaining the DRG Denials correspondence. Responsible for reviewing and organizing denial letters by third-party payor, accurately analyzing and abstracting key data information into the proper data fields. Identify root cause and financial impact. Presents all payer denial letters to Physician Advisors and CDI Director for review.

Experience

Three years Inpatient coding experience with ICD-10-CM/PCS required. In Lieu of education requirements, 5 years of acute care or 5 years inpatient coding experience required. Must have strong knowledge of Coding regulations and regulatory compliance experience.

Education

Associates degree in HIM, Business or related field required.

Licensure, Registration, and/or Certification

Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT)

About Us

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination. Cook Children’s is a Texas-only employer. If you are hired, you will need to maintain your primary residence within the state of Texas, along with all licenses and credentials required for your position throughout your employment.

Promise, a strong word with deep meaning that everyone understands—especially kids. This is the foundation of our organization and what drives us to blaze new trails in medical care, research, advanced technology, as well as programs and initiatives that benefit children who may not otherwise have access to quality health care. Every day our employees come to work with the intention of keeping our Promise. It's the guiding principle that helps our patients and their families get better and stay healthy. As a member of our Cook Children's team, you can be an important part of making that happen.