Job Opportunity Details

Job ID Specialty Geographic Location City State Recruiter
1922043 Hospital/Clinic – Medical Coder District of Columbia DC Acuity Search Solutions, Inc.

In HouseID:
Recruiter Email: jlenhart@acuitymri.com

Job Description

This is a Hospital/Clinic – Medical Coder Opportunity Only!

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Company Name: Acuity Search Solutions, Inc.
Recruiter Name: John Lenhart
Contact Phone: 513-206-9873

Job Title: Denials Analyst

(Only QUALIFIED Healthcare Professionals accepted) Hospital/Clinic – Medical Coder - Coding Denials Analyst Needed!

Full-time, Permanent opportunity with one of the Top 10 Ranked Hospitals in the country!

Call David at: 513-206-9881 or Email resume to: dlutz@acuitymri.com

The Clinical Denials Analyst will demonstrate expertise in reviewing clinical denials and providing recommendations for capturing accurate reimbursement. This analyst is responsible for reviewing denials for both technical and professional services. This analyst will be required to access billing systems, clinical EHR, and coding applications to perform daily tasks. The Clinical Denials Analyst will serve as a subject matter expert for the Revenue Cycle team as well as for external clinical stakeholders for all questions related to clinical denials and process improvement opportunities. This role will ensure compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines.

Minimum Education

Associate's Degree

Specific Requirements And Preferences

Specific Requirements and Preferences
Certification in Coding required. CCS or CPC-P|H.

Minimum Work Experience

5 years of medical records coding-related experience

1 year of experience in Billing or Denials audit function

Required Skills|Knowledge

Demonstrates excellent organizational and problem-solving skills. Ability to communicate professionally with physicians, third party payers and other organization members relative to the coding principles, logic and process. Demonstrates the ability to accurately review the medical record and associated billing information required to support reimbursement for services rendered. Relies on experience and superior judgment to accomplish goals. Possesses a strong understanding of Coding processes and their relation to the overall Revenue Cycle data flow| third party reimbursement. Maintains confidentiality of the record content at all times.


Functional Accountabilities



Professional Services


Review clinical denials received from third-party payors

1.Provide feedback to the billing team on corrections that would allow for accurate reimbursement


2.Participate in recurring meetings to review denial trends


3.Manage all requests that come from Revenue Cycle teams related to coding questions on denials, escalating as needed, and conducting appropriate research


4.Serve as subject matter expert for Revenue Cycle regarding clinical and technical denials


5.Assist Revenue Cycle Analytics team with compiling denial reports for clinical departments


6.Analyze process improvement opportunities for coding team to identify denial risks mid-cycle


7.Evaluate the medical record for documentation consistency and adequacy. Review the records for compliance with established third party reimbursement agencies and special screening criteria


8.Ensure compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines


Training and Education


1. Provide coding and documentation assistance and education to clinicians, with a focus on preventing future denials and ensuring coding accuracy

2. Assist in education of coding and billing teams on issues related to clinical denials




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