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Acute Coding Appeals Specialist
@Ensemble RCM LLC
[Hiring] Acute Coding Appeals Specialist @Ensemble RCM LLC
Apr 04, 2025 - Ensemble RCM LLC is hiring a remote Acute Coding Appeals Specialist. đź’¸ Salary: $19.75 - $24.20/hr. đź“ŤLocation: USA.
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Role Description
The Acute Coding Appeals Specialist integrates medical coding principles and objectivity in the performance of coding appeals activities.
- Draws on ICD10CM, ICD10PCS, HCPCS, NCCI, CMS and CMG coding expertise and industry knowledge to substantiate coding principles to determine potential billing/coding issues, and quality concerns.
- Responsible for reviewing and writing appeals for inpatient Diagnosis Related Group (DRG) denials to support the assigned DRG and address the clinical documentation utilized in the decision-making process.
- Participates in client system education to ensure coding is supported by the patient's clinical documentation, coding/CDI guidelines, and other regulatory standards/guidelines.
- Maintains meticulous documentation, spreadsheets, account, and claim examples of root cause issues.
- Performs searches of governmental, payor-specific, hospital-specific, regulatory body, and literature rules, regulations, guidelines to identify coding and billing requirements.
- Assists in education and training for client coding companion as it relates to the outcomes of the coding appeals.
- Meets established productivity standards for coding appeals & coding certification requirement.
- Attends in-house sessions to receive updated coding information and changes in coding and/or regulations.
- Provides excellent customer service in an organized and efficient manner while maintaining a positive attitude.
Qualifications
- Previous inpatient facility coding experience, working appeals, denials, and edits.
- 5 years previous experience in coding, required.
- Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.
Requirements
- High School Diploma or GED required.
- Active Coding Certification (i.e. RHIA, RHIT, CCS, CIC, CPC, COC, etc.).
Benefits
- Bonus Incentives
- Paid Certifications
- Tuition Reimbursement
- Comprehensive Benefits
- Career Advancement
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| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
Back to Remote jobs >
All others
All others
|
Salary
đź’¸
$19.75 - $24.20/hr
|
Remote
Location
USA
|
|
Job Type
full-time
|
Posted
Apr 04, 2025
|
️
| đź“Ť | Be aware of the location restriction for this remote position: USA |
| ‼ | Beware of scams! When applying for jobs, you should NEVER have to pay anything. Learn more. |
