[Hiring] Coding Denial Analyst @Franciscan Alliance, Inc.

Role Description

The Hospital Inpatient Coding Denial Analyst is responsible for addressing coding related denials across Franciscan Alliance. Additionally, the Coding Denial Analyst monitors denial results and notifies Coding Leadership of any identified trends.

• Develops and submits well-supported appeal letters related to coding denials utilizing excellent written and communication skills.
• Reviews, researches, and responds to inquiries, denial management, and follow-up questions, according to Coding Department approved resources.
• Reviews and processes claims and edits for accuracy and insurance and coding compliance.
• Utilizes official coding guidelines and follows established policies and procedures, to determine accurate code selection based upon documentation in the medical record.
• Acts as a subject matter expert for coding, billing and payer edits and denials.
• Assesses and ranks denials priority to align with Rev Cycle goals.
• Assesses denial and takes action to adjust claim data and resubmit corrected claim, prepare and coordinate appeal response, and prepare avoidable write off documentation.
• Collaborates with coding leadership, to improve key performance indicators through trending denials.
• Coordinates timely response to denials, reaching out to other Franciscan Alliance departments, as well as payers when necessary through denial resolution.
• Recommends improvements/adjustments to workflow and system build in response to changes in reimbursement methodology, coding guidelines, regulatory standards, or department workflow changes to prevent denials.

Qualifications

• Associate's or Bachelor's Degree for Health Information Management - Preferred
• High School Diploma/GED - Required
• 3 years Coding - Required
• 1 year Coding Denials/Payer Experience - Preferred
• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required
• Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Preferred
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Preferred

Requirements

• TRAVEL IS REQUIRED: Never or Rarely
• JOB RANGE: Coding Denial Analyst - Hospital Inpatient $51001.60-$75868.00
• INCENTIVE: Not Applicable

Benefits

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.