A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.
The Inpatient Coding and Appeals Coordinator plays a vital role in the revenue cycle management of Rev Cycle Mid-Service by maintaining the financial integrity of the healthcare facility and ensuring adherence to regulatory requirements. They are responsible for reviewing and resolving denials related to inpatient services by evaluating and rectifying coding errors and ensuring compliance with healthcare regulations. This role corrects coding discrepancies to ensure accurate and compliant billing and reimbursement. Collaborates with and assists internal stakeholders to support code accuracy on pre-bill and post-billed accounts. This position requires strong coding expertise, strong clinical knowledge, analytical skills, and a deep understanding of healthcare reimbursement processes.
Denial/Audit Analysis : Review and analyze denied inpatient claims and external audit opportunities to identify the root causes, including coding errors, missing documentation, and other issues. Rectify identified coding issues using proper documentation and evidence for code changes or corrections to support timely revenue.
Coding Accuracy : Ensure accurate coding of diagnoses and procedures in compliance with current ICD-10 coding guidelines and AHA Coding Clinic as well as established clinical criteria for diagnoses.
Documentation Review : Collaborate with clinical documentation specialists to ensure the completeness and accuracy of patient records to support coding and billing processes.
Appeals : Prepare and submit appeals for denied claims, providing necessary documentation and supporting evidence to maximize reimbursement. Responsible for completing retrospective medical record audits of denied claims related to DRG reimbursement. Evaluate and provide appropriate documentation for third party payer denials to maintain the original DRG assignment to prevent financial loss.
Regulatory Compliance : Stay updated with coding and billing regulations, including changes to Medicare, Medicaid and commercial payer policies to ensure compliance. Work collaboratively with physicians and other clinical staff to obtain complete clinical information.
CCS, RHIT, or RHIA coding certification required and/or certification as an RN. Minimum of 3 years of inpatient coding experience and/or 3 or more years experience as a clinical documentation specialist. Strong knowledge of ICD-10 coding guidelines. Strong knowledge of clinical criteria for disease processes. Familiarity with inpatient reimbursement methodologies. Proficiency in using EHR and coding software. Excellent analytical and problem-solving skills. Strong communication and interpersonal skills. Attention to detail and ability to work independently. Knowledge of healthcare regulations and compliance requirements Experience in denials management and appeals is a plus This position allows a flexible schedule with the ability to work from home.
Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings. Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.
Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.
Job openings are posted for a minimum of seven calendar days. The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.
The University of Michigan is an equal opportunity/affirmative action employer.
About University of Michigan - Ann Arbor
A great university is made so by its faculty and staff, and Michigan is recognized as one of the best universities to work for in the country. The Michigan culture is known for engaging faculty and staff in all facets of the university to create a workplace that is vibrant and stimulating.For two consecutive years, the Chronicle of Higher Education has placed U-M in its "Great Colleges to Work For" survey. In particular, the university earns high marks for strong relations between faculty and administrators, a collaborative system of governance, strong pay and benefits, and a healthy work/life balance.
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