Remote Acute Coding Appeals Specialist

Ensemble Health Partners; Ohio; 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 seeks an experienced Acute Coding Appeals Specialist to review inpatient DRG denials and prepare robust coding appeals. You will leverage ICD-10-CM/PCS, HCPCS, CMS guidelines, and CMG concepts to validate codes and improve denials outcomes.

The role is remote with occasional on-site travel to client locations. A strong background in coding, denial management, and regulatory compliance is essential, along with a willingness to explore AI-enabled improvements in processes

Qualifications

• Inpatient facility coding experience with appeals/denials.
• Strong knowledge of ICD-10-CM/PCS, HCPCS, CMS rules and DRG logic.
• Ability to review clinical documentation and prepare robust coding appeals.
• Willingness to learn and apply AI-enabled process improvements.
• Remote work with travel to client sites as needed.

Responsibilities

• Prepare and write coding appeals for inpatient DRG denials.
• Review client documentation and coding guidelines to support accuracy.
• Research governmental and payor rules to inform coding and billing requirements.
• Educate and train client staff on coding and denial processes.
• Maintain thorough documentation and productivity per standards.
• Stay updated on coding changes and regulations.

Skills

Inpatient coding

Coding appeals

Regulatory knowledge

AI curiosity

Travel ready

Education

Active Coding Certification (RHIA, RHIT, CCS, CIC, CPC, COC, etc.)

Job description

Ensemble Health Partners seeks an experienced Acute Coding Appeals Specialist to review inpatient DRG denials and prepare robust coding appeals. You will leverage ICD-10-CM/PCS, HCPCS, CMS guidelines, and CMG concepts to validate codes and improve denials outcomes.

The role is remote with occasional on-site travel to client locations. A strong background in coding, denial management, and regulatory compliance is essential, along with a willingness to explore AI-enabled improvements in processes