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Description

Introduction

Do you want to join an organization that invests in you as an Impatient Coding Denial Specialist? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years.

This is a remote/work from home position.

Full-time 40 Hour Work Week!

Must have ACUTE CARE inpatient coding experience in a facility.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

+ Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.

+ Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.

+ Free counseling services and resources for emotional, physical and financial wellbeing

+ 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)

+ Employee Stock Purchase Plan with 10% off HCA Healthcare stock

+ Family support through fertility and family building benefits with Progyny and adoption assistance.

+ Referral services for child, elder and pet care, home and auto repair, event planning and more

+ Consumer discounts through Abenity and Consumer Discounts

+ Retirement readiness, rollover assistance services and preferred banking partnerships

+ Education assistance (tuition, student loan, certification support, dependent scholarships)

+ Colleague recognition program

+ Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

+ Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

_Note: Eligibility for benefits may vary by location._

You contribute to our success. Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Impatient Coding Denial Specialist like you to be a part of our team.

Job Summary and Qualifications

The Inpatient Coding Denials Specialist is a high-level coding expert responsible for investigating and resolving coding related denials from payers, preventing lost reimbursement and promoting denial prevention. The Inpatient Coding Denials Specialist will adhere to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. The Inpatient Coding Denials Specialist must ensure timely, accurate, and thorough appeals for all accounts assigned and apply critical thinking skills to ascertain root cause of denials.

What you will do in this role:

+ Analyzes documentation to support codes/DRGs and abstracted data (e.g., discharge disposition) for inpatient records for multiple facilities using ICD-10- CM and ICD-10-PCS to include:

Principal diagnosis code assignment

Secondary diagnosis code assignment

Procedure code assignment

Discharge disposition

+ Identifies and writes clear and concise appeal letters utilizing all available documentation, regulations and guidelines to defend the billed claim

+ Utilize the following resources to identify the root cause of the denial/downgrade

+ Explanation of Benefits/Remittance Advice

+ Payer denial/DRG downgrade letters

+ Complex NCD/LCD guidelines, CMS/AHCA policies and regulations

+ Federal Register, Center for Medicare and Medicaid Services, American Hospital Association, Food and Drug Administration, Medicare Administrative Contractors and payer websites

+ Escalates problem accounts/processes/trends and report opportunities to supervisor for denial prevention and coding education opportunities

+ Maintains or exceeds established productivity standards

+ Maintains or exceeds established accuracy standards 2 Job Description

+ As needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) or Coding Account Resolution Specialist III (CARS-III) duties

+ Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current

+ Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes/DRGs

+ Meets all educational requirements as stated in current Company and HSC policy

+ Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”

+ Other duties as assigned

Qualifications:

+ High School graduate or GED equivalent preferred, undergraduate (associate or bachelors) degree in HIM/HIT preferred.

+ Minimum 3 year of acute care hospital inpatient coding required, 5 years preferred

+ Experience working payer denials and/or coding auditing preferred

+ RHIA, RHIT or CCS preferred

**Parallon** provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

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"Good people beget good people."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are a family 270,000 dedicated professionals! Our Talent Acquisition team is reviewing applications for our Impatient Coding Denial Specialist opening. Qualified candidates will be contacted for interviews. **Submit your resume today to join our community of caring!**

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.