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Denials Management Coding Specialist in Altamonte Springs, FL at AdventHealth

Date Posted: 5/9/2019

Job Snapshot

  • Job Schedule
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Family
    Health Information Management
  • Travel
    Yes, 25 % of the Time
  • Shift
    1 - Day
  • Application Zone
    1-Shared Services
  • Organization
    AdventHealth Corporate

Job Description

Denials Management Coder AdventHealth Corporate

Location Address: 2600 Lake Lucien Dr, Maitland, FL 32751

Top Reasons To Work At AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential

Work Hours/Shift:

  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Investigating and resolving coding related denials from third party payers and promoting denial prevention
  • Conducting account history research as required, including navigating patient electronic medical records and reviewing documentation to determine the appropriate course of appeal
  • Collaborating with clinical staff and/or outside providers to obtain further information to be used in the coding and appeals process.
  • Evaluating coding denials to determine root causes and creating processes for denial prevention and avoidance.  
  • Providing reports, education, and training on identified coding denial trends and recommended remediation. 
  • Creating written appeals utilizing official coding guidelines, coding clinic, and CPT assistant as appropriate 
  • Assisting with payer audits as required

What You Will Need:

  • High school diploma or equivalent
  • At least 5 years recent acute care coding experience to include ED, ancillary, observation, and surgery coding.
  • Current RHIA, RHIT, or CCS certification or credential
  • Experience with HCPCS codes and resolution of OCE edits, SSI edits and CCI edits
  • Familiarity of the DRG reimbursement system
  • 5 years Outpatient coding experience
  • Medical Necessity and DRG appeal writing experience
  • Coding Audit experience

Job Summary:


The Denials Management Coding Specialist is responsible for investigating and resolving coding related denials from third party payers, preventing lost reimbursement and promoting denial prevention.  The Denials Management Coding Specialist addresses both Inpatient and Outpatient claims and serves as a resource for all coding related questions and guidance to the Centralized Denial Team.  The Denials Management Coding Specialist will adhere to the AHS Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Location | Organization | Category | Job Function