Inpatient Coding Denials Specialist

Company Overview

HHS is a private, family-owned business dedicated to caring for its team members and providing honest, quality-driven customer service. Founded in 1975, HHS now supports nearly 1,000 customers across various sectors including healthcare and hospitality.

Summary

We are seeking a Inpatient Coding Denials Specialist to join our dynamic team at HHS in the United States. This role is vital in ensuring accurate medical coding and billing processes that align with our commitment to quality service. The Coding Specialist will play a key role in supporting our healthcare clients by maintaining high standards of accuracy and efficiency.

Responsibilities

• Review inpatient documentation to support accurate ICD-10-CM and ICD-10-PCS coding and DRG assignment.
• Write and submit clear, evidence-based appeal letters using medical records, coding guidelines, and payer policies.
• Investigate payer denials by reviewing remittance advice, denial letters, and regulatory guidance.
• Escalate problem accounts and report denial trends for process improvements.
• Meet or exceed productivity and accuracy standards.
• Stay current on coding guidelines, regulatory updates, and company policies.
• Occasionally perform Coding Integrity Specialist or Coding Account Resolution Specialist duties as needed.

Required Qualifications

• Certifications: CCS, RHIT, or RHIA
• Minimum 3 years of acute care inpatient hospital coding (5+ years preferred).
• Experience with DRG assignment and inpatient coding guidelines.
• Prior DRG appeal or payer denial resolution experience strongly preferred.
• Expert-level understanding of ICD-10-CM, ICD-10-PCS, MS-DRGs, APR-DRGs.
• Strong knowledge of inpatient coding guidelines and payer regulations.
• Excellent written and verbal communication skills (appeal letter writing required).
• Strong analytical and problem-solving abilities.
• Proficiency in Microsoft Office and EMR/coding systems
• Associate's or Bachelor's degree in Health Information Management or Health Information Technology preferred.