<ul><li>The appeals professional integrates medical coding principles and objectivity in the performance of coding appeals/denials 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</li><li>Participates in client system education to gain the knowledge necessary to appeal client accounts in ensuring that the coding is supported by the patient&#39;s clinical documentation, coding/cdi guidelines and other regulatory standards/guidelines as appropriate</li><li>Maintain 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 and coding and billing requirements to make recommendations to client</li><li>Assist in education and training for client coding companion as it relates to the outcomes of the coding appeals</li><li>Meet established productivity standards for coding appeals &amp; coding certification requirement</li><li>Attends in-house sessions to receive updated coding information and changes in coding and/or regulations</li><li>Provides excellent customer service, in an organized and efficient manner, while maintaining a positive attitude</li></ul><p><br></p>

<ul><li><strong>Active Coding Certification (i.e. RHIA, RHIT, CCS, CIC, CPC, COC, etc.) Required </strong></li><li>Previous inpatient facility coding experience, working appeals, denials and edits</li><li>5 years previous experience in coding, required</li><li>Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements</li><li>High School Diploma or GED</li><li><strong>Contract type</strong>: Permanent </li><li><strong>Pay</strong>: based on experience and location </li><li><strong>Hours</strong>: Monday-Friday 8am- 5pm (Flexible but may need to be available outside of their normal hours if there is a team meeting or a client needs) </li><li><strong>Location:</strong> Remote – (Cannot reside in California, New York, &amp; Colorado)</li></ul><p><br></p>

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