Lehighbar
Towson, MD
Position Summary We are seeking an experienced Inpatient Hospital Coder – Denial Appeals Specialist to review, analyze, and write compelling appeals for coding and DRG-related denials. This position requires a strong understanding of inpatient coding guidelines, MS-DRG assignment, clinical documentation, payer policies, and reimbursement principles.
Key Responsibilities Review inpatient coding and DRG denial cases to identify the reason for denial and determine the appropriate appeal strategy.
Analyze medical records, coding, clinical documentation, and payer denial rationale.
Write detailed, persuasive appeals addressing coding, sequencing, diagnosis/procedure assignment, and DRG-related denials.
Apply ICD-10-CM and ICD-10-PCS Official Guidelines for Coding and Reporting and other applicable coding standards.
Evaluate MS-DRG assignments and identify discrepancies between the documented clinical circumstances and the payer's determination.
Research and reference applicable coding...