Insight Global is seeking a Coding Denials and Appeals Analyst to support a large healthcare system based out of Annapolis, MD. The Coding Denials and Appeals Analyst supports the denial management team by reviewing claims denied for coding-related root causes, as well as suggesting process improvements to reduce future denials.

Working closely alongside the denial management department, the coding denial analyst is a liaison between coding and the business office and communicates issues with missing documentation, inaccurate coding, and other trends causing denials.

Principal duties and responsibilities:

Performs retrospective and prospective account reviews and resolves coding edits to ensure that coding is accurate, and documentation supports reimbursement.
Analyzes coding-related denials (for problems such as bundling issues and inappropriate CPT/diagnoses) to identify trends and root causes.
Develops process improvements for coding and documentation workflows based on denial analysis and industry coding guidelines.
Organizes data into clear reports that are presented to denial management leadership, physician advisors, and providers.
Provides regular feedback to denial management team members and coding/physician educators to promote departmental knowledge of best practices within coding.
May assist with communication to providers on outstanding queries for additional documentation or diagnosis information.
Proactively maintains current knowledge of applicable regulations and payer policy requirements, new or upcoming changes, and best practices from the AAP and professional journals.
Supports the denial coding team with additional tasks as needed (such as directly inputting codes on complex or high-value accounts).

HYBRID SCHEDULE: Flexible hours with at least 2 days/week on site (Tues, Weds or Thurs) - Monday + Friday is REMOTE

Requirements:

Associates Degree in business, healthcare, or related field
At least 3 years of coding, denial management, and/or reimbursement experience (inpatient/outpatient)
Current coding certification (RHIA, RHIT, CPC, CCS)

Preferred Qualifications:

Bachelor's Degree in business, healthcare, or related field.

Insight Global

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