Job Description

Position Overview

We are seeking an experienced Inpatient Coding Denials Specialist to review and resolve inpatient coding-related denials and prevent lost reimbursement. The ideal candidate has strong inpatient coding expertise, DRG assignment experience, and the ability to write effective clinical/coding appeals.

In this role, you will review medical documentation, ensure coding accuracy, validate DRG assignments, develop appeal letters, and collaborate with leadership to address denial trends and prevention strategies.

Schedule: MondayFriday, Days (Core hours 8:00 AM4:00 PM EST; flexible after training; no weekends)

Work Environment: Remote, office-based

Key Responsibilities

• Review inpatient medical records and assign accurate diagnoses, procedures, DRGs, and discharge dispositions
• Analyze denials, validate DRGs, and develop clear and effective appeal letters
• Research payer policies and regulatory resources, including CMS and NCD/LCD guidelines
• Identify trends and recommend denial prevention strategies
• Maintain productivity, accuracy, credentialing, and compliance standards
• Stay current with coding guidelines and participate in ongoing education

Required Qualifications

• CCS, RHIT, or RHIA credential required
• 3+ years acute care inpatient coding experience (5+ preferred )
• Experience with DRG assignment (denial/appeals experience preferred)
• Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRGs , and inpatient coding guidelines
• High level of accuracy, analytical ability, and communication skills
• Skilled in Microsoft Office and able to work independently and meet deadlines

Education

• High school diploma/GED required
• HIM/HIT degree preferred

Additional Experience

• Prior coding audit/denials experience a plus

Physical/Work Requirements

• Remote work; requires sustained computer use and sitting
• Ability to lift up to 25 lbs occasionally

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