Senior Coding Auditor: Denial Management & Revenue Recovery

Baylor Scott & White Health; Bismarck (ND); On-site; USD 70,000 - 100,000; Full time

Job summary

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review inpatient and outpatient coding denials, apply ICD-10-CM/PCS, CPT/HCPCS, and payer policies, and develop persuasive appeal strategies.

You will partner with Clinical Validation RNs to ensure supporting documentation and coding accuracy. Ideal candidates bring 6+ years in coding audits, strong analytical and communication skills, and experience with Epic and reimbursement workflows in a

Qualifications

• Six years of coding, audits, denial management or revenue cycle experience.
• Certification in CPC/CCS/RHIA/RHIT or equivalent preferred.
• Proficiency with Epic, encoder software and payer portals required.

Responsibilities

• Review and audit coding denials to determine resolution and appeal strategies.
• Investigate and appeal HB and PB denials including DRG downgrades and MUEs.
• Apply ICD-10-CM/PCS, CPT, HCPCS concepts and payer rules in evaluations.
• Prepare concisely documented appeal submissions with evidence.
• Identify denial trends and perform root cause analysis to guide improvements.
• Communicate findings and trends to leadership and stakeholders.

Skills

Analytical skills

Written communication

Verbal communication

Collaboration

Prioritization

Education

HS diploma or GED

Associate's or Bachelor's in HIM/Healthcare Admin

RHIA/RHIT/CCS/CCS-P/CPC/COC

Tools

Epic

Encoder software

Payer portals

Excel

Word

Job description

Baylor Scott & White Health is seeking a DRC Coding Auditor to join the Denial Resource Center. You will review inpatient and outpatient coding denials, apply ICD-10-CM/PCS, CPT/HCPCS, and payer policies, and develop persuasive appeal strategies.

You will partner with Clinical Validation RNs to ensure supporting documentation and coding accuracy. Ideal candidates bring 6+ years in coding audits, strong analytical and communication skills, and experience with Epic and reimbursement workflows in a