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Denials Prevention/Appeals Specialist

Job Summary

The Denials Prevention and Appeals Specialist is responsible for ensuring the accuracy and integrity of coding and billing processes within Michigan Medicine. This position plays a pivotal role in revenue cycle management by developing and executing robust denials prevention programs, conducting regular audits, and offering continuous training to staff. The specialist ensures compliance with all relevant regulations and contributes to the financial health of the organization by proactively addressing and preventing coding discrepancies.

Mission Statement

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.

Responsibilities*

Characteristic Duties and Responsibilities:

+ Audit and Denial Analysis:

+ Training and Development:

+ Coding and Compliance:

+ Collaboration and Communication:

+ Regulatory Monitoring:

+ Reporting and Improvement:

Required Qualifications*

+ CCS, RHIT, or RHIA coding certification required; certification as an RN is also acceptable.

+ Minimum of three years of inpatient coding experience or equivalent experience as a clinical documentation specialist.

Desired Qualifications*

+ Proven experience in training and educational program development preferred.

+ Extensive knowledge of ICD-10 coding guidelines and clinical criteria for disease processes.

+ Familiarity with inpatient reimbursement methodologies and denials management.

+ Strong analytical and problem-solving skills.

+ Excellent communication and interpersonal skills, with a focus on customer service.

+ Proficiency in EHR and coding software applications.

+ Self-motivated and capable of working independently with attention to detail.

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about thework modes (https://hr.umich.edu/working-u-m/my-employment/ways-we-work-resource-center/ways-we-work-implementation-group/modes-work) .

Background Screening

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.

Application Deadline

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.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.

Job Detail

Job Opening ID

266022

Working Title

Denials Prevention/Appeals Specialist

Job Title

Medical Coder Compliance Spec

Work Location

Michigan Medicine - Ann Arbor

Ann Arbor, MI

Modes of Work

Mobile/Remote

Full/Part Time

Full-Time

Regular/Temporary

Regular

FLSA Status

Exempt

Organizational Group

Exec Vp Med Affairs

Department

MM Rev Cycle (PTO)

Posting Begin/End Date

7/11/2025 - 7/25/2025

Career Interest

Healthcare Admin & Support