Hospital Inpatient Coding Denial Analyst

Franciscan Health; United States; On-site; USD 51,001 - 75,868; Full time

Job summary

Franciscan Health is seeking a Coding Denial Analyst to join their team. This role involves developing and submitting appeal letters for coding denials, ensuring accuracy in claims, and collaborating with leadership to improve processes.

The ideal candidate will have an Associate's or Bachelor's Degree in Health Information Management, along with required coding experience and certifications. Join us to provide essential services in the health industry.

Qualifications

• 3 years experience in Coding is required.
• 1 year experience in Coding Denials/Payer is preferred.
• Certified Coding Specialist (CCS) or equivalent certification is required.

Responsibilities

• Develop and submit appeal letters related to coding denials.
• Review and process claims for accuracy.
• Coordinate timely responses to denials.

Skills

Coding

Communication skills

Research skills

Attention to detail

Education

Associate's or Bachelor's Degree for Health Information Management

High School Diploma/GED

Job description

WHO WE ARE

With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

WHAT YOU CAN EXPECT

• Develops and submits well-supported appeal letters related to coding denials utilizing excellent written and communication skills.
• Reviews, researches, and responds to inquiries, denial management, and follow-up questions, according to Coding Department approved resources.
• Reviews and processes claims and edits for accuracy and insurance and coding compliance.
• Utilizes official coding guidelines and follows established policies and procedures, to determine accurate code selection based upon documentation in the medical record.
• Acts as a subject matter expert for coding, billing and payer edits and denials.
• Assesses and ranks denials priority to align with Rev Cycle goals.
• Assesses denial and takes action to adjust claim data and resubmit corrected claim, prepare and coordinate appeal response, and prepare avoidable write off documentation.
• Collaborates with coding leadership, to improve key performance indicators through trending denials.
• Coordinates timely response to denials, reaching out to other Franciscan Alliance departments, as well as payers when necessary through denial resolution.
• Recommends improvements/adjustments to workflow and system build in response to changes in reimbursement methodology, coding guidelines, regulatory standards, or department workflow changes to prevent denials.

QUALIFICATIONS

• Associate's or Bachelor's Degree for Health Information Management - Preferred
• High School Diploma/GED - Required
• 3 years Coding - Required
• 1 year Coding Denials/Payer Experience - Preferred
• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required
• Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Preferred
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Preferred

TRAVEL IS REQUIRED: Never or Rarely

JOB RANGE: Coding Denial Analyst - Hospital Inpatient $51001.60-$75868.00

INCENTIVE: Not Applicable

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity.