Job Information
HCA Healthcare Inpatient Coding Denial Specialist in Nashville, Tennessee
Description
Introduction
Sign-On Bonus Eligible*
Do you have the career opportunities as an Inpatient Coding Denial Specialist you want with your current employer? We have an exciting opportunity for you to join Work from Home which is part of the nation's leading provider of healthcare services, HCA Healthcare.
Benefits
Work from Home, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)
Note: Eligibility for benefits may vary by location.
Our teams are a committed, caring group of colleagues. Do you want to work as an Inpatient Coding Denial Specialist where your passion for creating positive patient interactions is valued? If you are dedicated to caring for the well-being of others, this could be your next opportunity. We want your knowledge and expertise!
Job Summary and Qualifications
The Inpatient Coding Denials Specialist is a high-level coding expert responsible for investigating and resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain root cause of denials.
What you will do in this role:
- Analyzes documentation to support codes/DRGs and abstracted data (e.g., discharge disposition) for inpatient records for multiple facilities using ICD-10- CM and ICD-10-PCS to include:
Principal diagnosis code assignment
Secondary diagnosis code assignment
Procedure code assignment
Discharge disposition
Identifies and writes clear and concise appeal letters utilizing all available documentation, regulations and guidelines to defend the billed claim
Utilize the following resources to identify the root cause of the denial/downgrade
Explanation of Benefits/Remittance Advice
Payer denial/DRG downgrade letters
Complex NCD/LCD guidelines, CMS/AHCA policies and regulations
Federal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug Administration, Medicare Administrative Contractors and payer websites
Escalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunities
Maintains or exceeds established productivity standards
Maintains or exceeds established accuracy standards 2 Job Description
As needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) or Coding Account Resolution Specialist III (CARS-III) duties
Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current
Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes/DRGs
Meets all educational requirements as stated in current Company and HSC policy
Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”
Other duties as assigned
Qualifications:
High School graduate or GED equivalent preferred, undergraduate (associate or bachelors) degree in HIM/HIT preferred.
Minimum 3 year of acute care hospital inpatient coding required, 5 years preferred
Experience working payer denials and/or coding auditing preferred
RHIA, RHIT or CCS preferred
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Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
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"Bricks and mortar do not make a hospital. People do."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Coding Denial Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
*Some exclusions may apply. Must meet eligibility requirements.