Position: Denial Management Analyst – Coder
Denial Prevention Specialist is responsible for ensuring that all eligible accounts are appealed within the designated payer timeframes. The position is also responsible for analyzing the root cause analysis of the denied claims and develop corrective action plan for resolution of denials.

Responsibilities:

• Expertise in medical record review to abstract information required to support accurate Inpatient coding
• Expertise in assigning accurate ICD-9-CM, CPT, DRG, HCPCS and other service codes for diagnosis and procedures performed in the Inpatient setting.
• Applying advanced knowledge of medical terminology , anatomy and physiology, treatment modalities , diagnostic test, medications
• Adhere to the HAAD Claims and Adjudication rules and coding guidelines
• Providing orientation and coding education to coders, pre-authorization co-coordinators, denial prevention specialist , physicians and nurses regarding documentation and query effectively to ensure better documentation
• Acts as a resource when necessary for billing, pre-authorization and reimbursement issues and outpatient coding.

Requirements:

• Degree in any related field preferably life science background.
• CCS (AHIMA) or CPC (AAPC) certification is required.
• Minimum of five (6) years Outpatient coding experience in any setting i.e., hospital, clinic, or other related healthcare field is required.
  In addition to medical coding, knowledge of billing process will be a plus.
• Both inpatient and outpatient coding experience preferred.