Senior Coding Auditor: Denials & Revenue Recovery

Baylor Scott & White Health; Atlanta (GA); Presencial; USD 75.000 - 110.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health benefits

401(k) match

Tuition Reimbursement

PTO from Day 1

Descripción de la vacante

Baylor Scott & White Health, a leading health care system, seeks a DRC Coding Auditor to review and appeal complex coding denials across hospital and professional billing. You will apply ICD-10-CM/PCS, CPT, DRG rules, and payer policies to supporting documentation to optimize recovery.

Collaborating with Clinical Validation RNs and Revenue Cycle teams, you will analyze denial trends, perform root-cause analyses, and contribute to process improvements to reduce future denials and improve revenue

Formación

• Six+ years of coding/denial management experience.
• Experience auditing denials for Hospital Billing (HB) and Professional Billing (PB).
• Strong knowledge of ICD-10-CM/PCS, CPT/HCPCS, DRG, NCCI, and MUE guidelines.

Responsabilidades

• Review and audit coding-related denials to determine resolution and appeal strategies.
• Investigate and appeal HB and PB denials, including DRG downgrades and coding validation denials.
• Prepare concise appeal documentation with supporting coding references and medical records.

Conocimientos

Denial management

Coding audits

Analytical thinking

Communication

Educación

RHIA/RHIT/CCS/CPC

HS Diploma/GED

Herramientas

Epic

Encoder software

Payer portals

Excel

Word

Descripción del empleo

Baylor Scott & White Health, a leading health care system, seeks a DRC Coding Auditor to review and appeal complex coding denials across hospital and professional billing. You will apply ICD-10-CM/PCS, CPT, DRG rules, and payer policies to supporting documentation to optimize recovery.

Collaborating with Clinical Validation RNs and Revenue Cycle teams, you will analyze denial trends, perform root-cause analyses, and contribute to process improvements to reduce future denials and improve revenue