Professional Physicians Services Coding Denial Analyst

The Hospital Inpatient Coding Denial Analyst is responsible for addressing coding related denials across Franciscan Alliance. Additionally, the Coding Denial Analyst monitors denial results and notifies Coding Leadership of any identified trends., * Develops and submits well-supported appeal letters related to coding denials utilizing excellent written and communication skills.

• Reviews, researches, and responds to inquiries, denial management, and follow-up questions, according to Coding Department approved resources.
• Reviews and processes claims and edits for accuracy and insurance and coding compliance.
• Utilizes official coding guidelines and follows established policies and procedures, to determine accurate code selection based upon documentation in the medical record.
• Acts as a subject matter expert for coding, billing and payer edits and denials.
• Assesses and ranks denials priority to align with Rev Cycle goals.
• Assesses denial and takes action to adjust claim data and resubmit corrected claim, prepare and coordinate appeal response, and prepare avoidable write off documentation.
• Collaborates with coding leadership, to improve key performance indicators through trending denials.
• Coordinates timely response to denials, reaching out to other Franciscan Alliance departments, as well as payers when necessary through denial resolution.
• Recommends improvements/adjustments to workflow and system build in response to changes in reimbursement methodology, coding guidelines, regulatory standards, or department workflow changes to prevent denials.

Do you have a valid Certified Coding Specialist certification?, Do you have experience in Research?, Do you have a High school diploma or GED?, * Associate’s or Bachelor’s Degree for Health Information Management - Preferred

• High School Diploma/GED - Required
• 3 years Coding - Required
• 1 year Coding Denials/Payer Experience - Preferred
• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required
• Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) - Preferred
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) - Preferred

3.43.4 out of 5 stars Mishawaka, IN 46544 Remote $51,001.60 - $75,868.00 a year - Full-time

With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve., It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

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