Full-time, 40 hours/week

Monday-Friday 8am-4:30pm

Remote

Summary:

The Denial Coding Specialist supports the Revenue Recovery team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. Working closely alongside the Physician Advisor, the Denial Coding Specialist liaises between the Revenue Recovery team and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. This position reports to the Revenue Recovery Supervisor.

Responsibilities:

1. Performs retrospective account reviews and resolves coding denials accordingly.
2. Analyzes coding-related denials (e.g., bundling issues and inappropriate CPT/diagnoses) to identify trends and root causes
3. Proactively maintains current knowledge of applicable regulations, requirements, changes, and best practices by following industry sources (e.g., Centers for Medicare & Medicaid Services, American Association of Professional Coders, and professional journals)
4. Reviews EPIC work queues daily for Denial management and makes necessary and appropriate coding changes based on medical documentation for both professional and technical charge revenue.
5. Follows up with providers to resolve outstanding queries for additional documentation or diagnosis information
6. Coordinates and/or completes appeals as applicable with payors.
7. Develops suggestions for coding and documentation process improvements, based on denial analysis and industry coding guidelines
8. Extracts data into clear reports to revenue recover and revenue cycle leadership, physician advisor, and providers
9. Partners with Revenue Cycle team leaders, physicians, and providers to develop and implement process improvements
10. Provides regular feedback and ad-hoc education to revenue recovery staff and providers to promote departmental knowledge of appropriate coding practices
11. Other duties as required.

Other information:

Technical Expertise

1. Experience in CPT and ICD coding is required.
2. Experience working with all levels within an organization is required.
3. Experience working in an Electronic Medical Record system preferred
4. Experience in healthcare is preferred.
5. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required.

Education and Experience

• Education: High School Diploma or equivalent is required; Bachelor's degree is preferred.
• Certification: AAPC or AHIMA Coding Certification is required.
• Years of relevant experience: 0 to 2 years is preferred.
• Years of experience supervising: None.

Credentials

Essential (minimum one as applicable):

• American Academy of Professional Coders
• American Health Information Management Association
• Certified Provider Credentialing Specialist
• Certified Coding Specialist
• Registered Health Information Technician
• Certified Coding Associate

Full Time

FTE: 1.000000

Status: Remote

About Akron Children's

More Than a Job. It’s loving what you do - and why you do it. Akron Children’s Hospital is ranked among the best pediatric hospitals by U.S. News & World Report, but it’s our compassionate approach to treatment that sets us apart. It’s creating special high-fives. Thinking of new ways to spark a smile. Holding hands to offer comfort. And working to get a giggle that brightens a room. The minute you walk into Akron Children’s, you can sense that people here love what they do. From visits with the Doggie Brigade, to the balloons and smiles in the halls, the sights and sounds are all about one thing: the children. We are the largest pediatric healthcare system in Northern Ohio and one of the fastest growing in the country. Akron Children’s has two hospital campuses in Northeast Ohio: one in Akron and the other in Boardman in the Mahoning Valley. With two hospital campuses, regional health centers and more than 50 primary and specialty care locations throughout Ohio, we’re making it easier for today’s busy families - regardless of where they live - to find the high-quality care they need. No matter which of our locations you choose, you’ll see that when you give the most, you get more—...support, rewards and satisfaction. CAREER OPPORTUNITIES: It’s making the most of your days. Our passion is felt every day in the way people care at every level. Whether you are working with children face-to-face, or behind the scenes supporting the care and services we deliver, you impact futures. Visit us and see why it’s more than just a place to work. It’s a family. Apply today at careers.akronchildrens.org.

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