Remote Coding Appeals Specialist Job at Robert Half (Indianapolis)

Remote Inpatient Coding Specialist

Join our client's team as a Remote Inpatient Coding Specialist and play an essen...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

MIN 5 years of coding experience as a direct contributor
MIN 1 year of specific Inpatient/Facility coding experience
Experience with medical coding appeals and denials highly preferred
Strong understanding of healthcare regulatory standards and quality assurance principles
Demonstrated proficiency in ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG coding systems
All applicants applying for U.S. job openings must be legally authorized to work in the United States

Job Responsibility

Apply medical coding principles and industry guidelines objectively during appeals and denial review processes
Leverage knowledge of ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG to identify, analyze, and resolve billing and coding issues
Assess quality concerns by verifying adherence to regulatory requirements and best practices
Participate in client system education to gain familiarity with specific platforms and workflows
Ensure all appeals are accurately supported by clinical documentation, coding/CDI guidelines, and regulatory standards
Collaborate with clients and internal stakeholders to clarify documentation and coding requirements

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Remote Inpatient Coding Specialist

Join our team as a Remote Inpatient Coding Specialist and play an essential role...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

MIN 5 years of coding experience as a direct contributor
MIN 1 year of specific Inpatient/Facility coding experience
Experience with medical coding appeals and denials highly preferred
Strong understanding of healthcare regulatory standards and quality assurance principles
Demonstrated proficiency in ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG coding systems

Job Responsibility

Apply medical coding principles and industry guidelines objectively during appeals and denial review processes
Leverage knowledge of ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG to identify, analyze, and resolve billing and coding issues
Assess quality concerns by verifying adherence to regulatory requirements and best practices
Participate in client system education to gain familiarity with specific platforms and workflows
Ensure all appeals are accurately supported by clinical documentation, coding/CDI guidelines, and regulatory standards
Collaborate with clients and internal stakeholders to clarify documentation and coding requirements

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Hb coding integrity specialist - inpatient denials

Reviews coded health information records to evaluate the quality of staff coding...

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA), or Health Information Administrator (RHIA) registration issued by AHIMA, or Health Information Technician (RHIT) registration issued by AHIMA
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams
Advanced knowledge and understanding of anatomy and physiology, medical terminology, pathophysiology (disease process, surgical terminology and pharmacology.)
Advanced knowledge of pharmacology indications for drug usage and related adverse reactions
Expert knowledge of coding work flow and optimization of technology including how to navigate in the electronic health information record and in health information management and billing systems

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Hb coding integrity specialist - inpatient denials

Reviews coded health information records to evaluate the quality of staff coding...

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions

Fulltime

Hb coding integrity specialist - outpatient denials

Reviews coded health information records to evaluate the quality of staff coding...

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by AHIMA
Health Information Technician (RHIT) registration issued by AHIMA
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Hospital Coding Quality Specialist - Inpatient

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Hb coding integrity specialist - outpatient denials

Reviews coded health information records to evaluate the quality of staff coding...

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by AHIMA
or Health Information Administrator (RHIA) registration issued by AHIMA
or Health Information Technician (RHIT) registration issued by AHIMA
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Hospital Based Outpatient Surgery Coding Experience is required
Denials related experience is preferred
Demonstrated leadership skills and abilities
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

Remote Medical Accounts Receivable Specialist

We are looking for a remote detail-oriented Medical Accounts Receivable Speciali...

Location

United States , Saint Paul

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience with NX (MyAvatar) or Aura – Sigmund is required
Experience working in medical accounts receivable, medical billing, or denial resolution within a healthcare environment
Demonstrated ability to research and resolve insurance denials, underpayments, and rejected claims across commercial payers
Knowledge of accounts receivable workflows, collections activity, cash applications, and billing functions related to healthcare claims
Familiarity with payer guidelines, appeals processes, and compliance standards governing claim submission and reimbursement
Ability to interpret explanation of benefits information, analyze account discrepancies, and determine appropriate next steps for resolution
Strong written and verbal communication skills with the ability to document follow-up clearly and prepare accurate appeal correspondence

Job Responsibility

Investigate denied, rejected, and partially reimbursed claims to determine the cause of nonpayment and drive timely resolution
Take corrective action on accounts by submitting claim adjustments, preparing reconsiderations, gathering needed documentation, and filing appeals in line with payer requirements
Manage assigned receivables by reviewing aging reports, prioritizing high-risk accounts, and working toward monthly collection and resolution goals
Communicate with insurance carriers to verify claim status, clarify adjudication outcomes, and escalate unresolved issues when additional review is required
Examine differences between submitted charges and payer payments to identify billing inconsistencies, underpayments, and reimbursement discrepancies
Partner with billing, coding, and clinical teams to correct claim edits, address authorization concerns, and resolve denial issues related to coding or documentation
Maintain complete account notes and follow-up records so all activity is accurately documented for audit readiness and operational visibility
Use electronic medical record and revenue cycle systems, including NX (MyAvatar) and Aura – Sigmund, to review account activity, claim history, and supporting encounter information
Prepare and share reporting on denial categories, payer behavior, and accounts receivable performance to help identify trends and support process improvement efforts

What we offer

Medical, vision, dental, and life and disability insurance
Enrollment in company 401(k) plan

Fulltime

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Remote Coding Appeals Specialist

Job Description

Job Responsibility

Requirements

What we offer

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