Summary
Why Join the Health Information Management Inpatient Coding Team?
At Michigan Medicine, our Outpatient Coding Denials Specialist plays a vital role in the revenue cycle management of Rev Cycle Mid-Service by maintaining the financial integrity of the healthcare facility and ensuring adherence to regulatory requirements. They are responsible for reviewing and resolving denials related to outpatient professional/facility services by evaluating and rectifying coding errors and ensuring compliance with healthcare regulations. This role corrects CPT coding discrepancies to ensure accurate and compliant billing and reimbursement. Collaborates with and assists internal stakeholders to support code accuracy on pre-bill and post-billed accounts. This position requires strong coding expertise, analytical skills, and a deep understanding of healthcare reimbursement processes.
What Perks and Benefits Can You Look Forward to?
- 2:1 match on retirement savings
- Excellent medical, dental, and vision coverage starting on day one of employment
- Generous Paid Time Off (PTO) and paid holidays
- Continuing education opportunities
- Flexible schedule
- Work from home
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*
- You will review and analyze denied outpatient claims and external audit opportunities to identify the root causes, including coding errors, missing documentation, and other issues. Rectify identified coding issues using proper documentation and evidence for code changes or corrections to support timely revenue.
- You will ensure accurate coding for outpatient procedures, diagnoses, and services in compliance with current ICD-10, CPT, and HCPCS coding guidelines.
- You will Collaborate with clinical documentation specialists to ensure the completeness and accuracy of patient records to support coding and billing processes.
- You will prepare and submit appeals for denied claims, providing necessary documentation and supporting evidence to maximize reimbursement.
- You will maintain records of denials trends, appeals outcomes, and revenue recovery statistics, and provide regular reports to management.
Required Qualifications*
- One of the following certifications:
- Certified Professional Coder (CPC) coding certification.
- Clinical Coding Specialist (CCS) and registration with the American Health Information Management Association
- Associate's degree in Health Information Technology and registration with the American Health Information Management Association as a RHIT or RHIA
- Minimum of 3 years of outpatient coding experience.
- Strong knowledge of ICD-10, CPT, and HCPCS coding guidelines.
Desired Qualifications*
- Proficiency in using EHR and coding software.
- Excellent analytical and problem-solving skills.
- Strong communication and interpersonal skills.
- Attention to detail and ability to work independently.
- Knowledge of healthcare regulations and compliance requirements
- Experience in denials management and appeals is a plus.
Work Schedule
The position allows for a flexible schedule. The core business hours are between 6:00AM-4:30PM, Monday-Friday.
Additional Information
Supervision Received
General supervision is received from Coding Compliance and Education Manager.
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/AA Statement
The University of Michigan is an equal opportunity/affirmative action employer.