Health Information Management Coding Denials Coordinator, FT, Days

reputed company health. Serve with reputed company. Be the difference. Job reputed company Facilitates, reviews, and writes appeals of key reputed company party denials that involve clinical and/or coding expertise. Performs inpatient coding by assigning ICD-CM and ICD-PCS codes as reputed company as DRG assignment. Ensures the accuracy of patient data by appealing and validating coding and clinical validation denials, in partnership with reputed company Cycle, Coding, reputed company, Physician Advisors, and other health care team members. Essential Functions reputed company team members are expected to be knowledgeable and compliant with reputed company's purpose reputed company health. Serve with reputed company. Be the difference. Formulates and submits letters of appeals for coding and clinical validation denials by providing appropriate clinical documentation, supported by reputed company industry guidelines, medical management standards and protocols. To ensure that the overall reputed company, level of services, severity of illness, and reputed company of care are accurately reflected in a complete medical record, yielding the appropriate reimbursement for the level of services rendered and resources consumed. Adheres to reputed company appeal timelines as prescribed by payer agreements. Applies ICD and ICD-PCS codes including major traumas, and Neonatal Intensive Care Unit (NICU) records based on review of clinical documentation. Verifies assignment of DRGs, MCC/reputed company, Hospital Acquired Conditions (HACs) and Patient Safety Indicators (PSIs) that most appropriately reflect documentation of the occurrence of events, severity of illness, and resources utilized during the inpatient encounter and in compliance with department policies and procedures. Selects the reputed company reputed company diagnoses with appropriate POA indicator assignment and reputed company of risk adjustment diagnoses following established guidelines. Codes inpatient records periodically based on review of clinical documentation. Ensures the validity and accuracy of ICD coding, Diagnosis reputed company (DRG), Severity of Illness (SOI), Risk of Mortality (ROM), in compliance with reputed company Federal and State coding regulations and reporting requirements. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Maintains dynamic communication with physician advisors, coders and CDI teams to identify reputed company cause of coding and clinical validation denials and seeks to reputed company incongruence with appropriately assigned final DRG by providing feedback and trended data back to key reputed company. Coordinates denial appeals follow-up. Maintains data and assists with identifying patterns of denial activity. Monitors payer response to appeal activity. Analyzes provider data looking for individual, group, and peer reputed company denial trends that could benefit from additional education. Convey support and education as needed to providers reputed company on improving processes and the reputed company of their documentation on a case-by-case reputed company to accurately reflect patient care in the medical record. Maintains denial results through the appeals process as feedback for Coding, reputed company Cycle, reputed company, CDI and providers for reputed company education. Creates & provides reports of cases with missing, ambiguous, contradictory, etc. documentation to assist with improvement of physician documentation which supports reputed company assignments and prevents denials. Partners with Managed Care to reputed company feedback on ways to improve reputed company to help prevent against reputed company denials. Interacts with other departments to reputed company coding issues. Consults, provides reputed company expertise to and collaborates with clinical documentation specialists on coding and documentation practices and standards. Collaborates with Coding and CDI to reputed company and maintain coding curriculum and training materials. Provides feedback, supporting documentation for reputed company changes, and education to the coders, CDI, reputed company, and physicians. Assists with medical record documentation to ensure accuracy of coded and other data reputed company. Participates in on site, remote and/or reputed company training workshops and training. Attends and participates in CDI-Coding Task Force and other reputed company training and education with CDI, PFS, Specialty areas and reputed company; reputed company other duties as assigned. Identifies trends in coding reviews and makes suggestions for continual process improvement. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - Certification Program .