Remote Acute Coding Appeals Specialist

Ensemble Health Partners; Columbus (OH); Remote; USD 41,000 - 44,000; Full time

Benefits offered by this job

Bonus Incentives

Paid Certifications

Tuition Reimbursement

Comprehensive Benefits

Career Advancement

Job summary

Ensemble Health Partners is seeking a Remote Coding Appeals Specialist to join our team and support hospital and health system clients nationwide. You will apply ICD10CM/PCS, HCPCS, NCCI, CMS and CMG guidelines to substantiate coding decisions and draft DRG-related appeals with precision.

Responsibilities include maintaining meticulous documentation, educating clients on coding requirements, and collaborating to improve patient care outcomes while meeting productivity and certification

Qualifications

• Previous inpatient facility coding experience, working appeals, denials and edits.
• 5 years previous experience in coding, required.
• Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.
• Must be inquisitive and demonstrate openness to innovation including AI to explore better processes and ways to alleviate friction and improve patient and client experiences.

Responsibilities

• Draws on ICD10CM, ICD10PCS, HCPCS, NCCI, CMS and CMG coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns.
• Participates in client system education to gain the knowledge necessary to appeal client accounts in ensuring that the coding is supported by the patient’s clinical documentation, coding/cdi guidelines and other regulatory standards/guidelines as appropriate.
• Maintain meticulous documentation, spreadsheets, account, and claim examples of root cause issues.
• Performs searches of governmental, payor‑specific, hospital‑specific, regulatory body, and literature rules, regulations, guidelines to identify and coding and billing requirements to make recommendations to client.
• Assist in education and training for client coding companion as it relates to the outcomes of the coding appeals.
• Meet established productivity standards for coding appeals & coding certification requirement.
• Attends in‑house sessions to receive updated coding information and changes in coding and/or regulations.
• Provides excellent customer service, in an organized and efficient manner, while maintaining a positive attitude.

Skills

inpatient coding experience

Education

High School Diploma or GED

Tools

Medical coding systems

Job description

Ensemble Health Partners is seeking a Remote Coding Appeals Specialist to join our team and support hospital and health system clients nationwide. You will apply ICD10CM/PCS, HCPCS, NCCI, CMS and CMG guidelines to substantiate coding decisions and draft DRG-related appeals with precision.

Responsibilities include maintaining meticulous documentation, educating clients on coding requirements, and collaborating to improve patient care outcomes while meeting productivity and certification