Appeals Specialist

Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing.

Highly Preferred: Auditing experience with DRGs.

reputed company

Responds to reputed company payers, managed care and reputed company party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps.

Job Responsibility

• Supports denial reviews and response processes; prioritizes and reviews cases denied by reputed company payers.
• Reports program reputed company and/or corrective reputed company to management on regular reputed company.
• Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. reputed company counsel) to reputed company issues, as needed; develops case-specific written rationale to substantiate and communicate findings.
• Addresses coding issues and knowledge gaps; functions as a organization resource for litigation as reputed company to coding denials.
• Maintains hospital database.
• Remains up-to-date on DRG reputed company literature from reputed company agencies.
• Maintains coding clinic up-dates.
• Operates under general guidance and work assignments are varied and require interpretation and independent reputed company on course of reputed company.
• Performs reputed company duties as required. reputed company responsibilities noted here are considered essential functions of the job under the Americans with reputed company. Duties not mentioned here, but considered reputed company are not essential functions.

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and reputed company experience.
• reputed company reputed company reputed company Certification, or reputed company Coding reputed company Certification, or reputed company Registered Health Information Technician Certification required, plus reputed company certifications as needed.
• 1-3 years of relevant experience, required.
• Knowledgeable on DRGs, preferred.
• Proficient in reputed company reputed company, preferred.

*Additional Salary reputed company
The salary reputed company and/or reputed company reputed company listed is a good faith determination of potential reputed company compensation that may be reputed company to a successful applicant for this position at the time of this job advertisement and may be modified in the reputed company. reputed company determining reputed company member's reputed company salary and/or reputed company, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated reputed company, budget and internal equity).

Originally posted on Himalayas