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Acute Coding Appeals Specialist

https://www.roberthalf.com Logo

Robert Half

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Location:
United States , Minneapolis

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

The Acute Coding Appeals Specialist reviews and writes appeals for inpatient DRG denials to support accurate code assignment and reimbursement. This role applies advanced ICD-10, DRG, CMS, and payer-specific knowledge to defend coding decisions, ensure compliance, and address billing and documentation concerns.

Job Responsibility:

  • Review inpatient DRG denials and draft well-supported appeal letters using ICD-10-CM/PCS, HCPCS, NCCI, CMS, and CMG guidelines
  • Analyze clinical documentation to validate the originally assigned DRG and ensure compliance with regulatory standards
  • Research payer policies, government regulations, and industry guidelines to strengthen appeal arguments
  • Maintain detailed documentation, tracking spreadsheets, and root cause analyses for denial trends
  • Collaborate with client coding and CDI teams to provide education based on appeal outcomes
  • Meet established productivity and quality standards while maintaining coding certification requirements
  • Stay current on coding updates, regulatory changes, and reimbursement rules
  • Deliver professional, organized, and customer-focused communication with clients

Requirements:

  • 5+ years of inpatient facility coding experience (required)
  • Experience handling appeals, denials, and claim edits
  • Advanced knowledge of coding systems, billing processes, and regulatory standards
  • Strong research, analytical, and written communication skills
  • Ability to track trends and identify root cause issues
  • High School Diploma or GED (minimum)
  • Active coding certification required (RHIA, RHIT, CCS, CIC, CPC, COC, etc.)
What we offer:
  • medical
  • vision
  • dental
  • life and disability insurance
  • 401(k) plan

Additional Information:

Job Posted:
March 13, 2026

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