Remote Coding/CDI Denials Analyst - DRG & Appeals

University of Texas Southwestern Medical Center; Dallas (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

PPO medical plan

100% coverage for preventive care

Paid Time Off

TRS retirement program

Paid parental leave

Wellness programs

Tuition reimbursement

PSLF-qualified employer

Job summary

UT Southwestern Medical Center in Dallas, TX is seeking a Coding/CDI Denials Analyst to review inpatient coding denials for accuracy and to ensure supporting documentation aligns with Official Coding Guidelines and DRG assignments.

The role includes composing appeals, identifying trends for root causes of denials, and communicating findings to support process improvements across Coders and CDI teams.

Qualifications

• 3 years to 5 years acute hospital-based Coding and/or CDI experience.
• Denials and Appeals experience in an acute Hospital setting.
• Experience working in a remote environment.

Responsibilities

• Review coding and/or clinical denials, ensuring all coding guidelines and conventions were followed, and ensuring all clinical evidence and provider documentation supports the assigned codes and DRG.
• Compose an effective appeal utilizing appropriate coding guidelines, relevant and effective clinical documentation, current industry guidelines, evidence-based medicine, and local and national medical management standards and protocols.
• Identify coding and/or documentation trends for root causes of denials.
• Identify and communicate DRG changes and financial impact.
• Identify coding and clinical educational opportunities and report these to the Lead Denials Analyst.
• Identify front-end activities that influence denial/appeals process.
• Support the Quality Standards set by UTSW and the HIM Coding & CDI Department.
• Maintains an expert level of knowledge of Coding/CDI guidelines and practices.
• Other duties as assigned.

Skills

Coding/CDI experience

Denials & Appeals

Remote work experience

Education

RHIA

RHIT

CCS

CCDS

CDIP

Job description

UT Southwestern Medical Center in Dallas, TX is seeking a Coding/CDI Denials Analyst to review inpatient coding denials for accuracy and to ensure supporting documentation aligns with Official Coding Guidelines and DRG assignments.

The role includes composing appeals, identifying trends for root causes of denials, and communicating findings to support process improvements across Coders and CDI teams.