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Inpatient Coding Resolution Specialist Jobs in Alabama

Trice Healthcare

Coding Payment Resolution Spec

Homewood, AL · On-site

$18.75 - $24/hr

Coding Payment Resolution Specialist Responsible for reviewing all post-billed denials (inclusive ... or inpatient claims, or other coding reasons and processing charge corrections based on medical ...

Infirmary Health

Coder III

Mobile, AL · On-site

Certified Coding Specialist (CCS) * OR * Credentialed through American Academy of Professional Coders (AAPC) * Certified Inpatient Coder (CIC) Desired Qualifications: * Associate's Degree Desired ...

Highmark Health

Supervisor Coding

Montgomery, AL · On-site

$48.54/hr

Makes process improvements or initiates courses of action for problem resolution. (10%) * Performs ... codes (inpatient), CPT/HCPCS codes. * Excellent organizational and project management skills * 1 ...

Intermountain Health

PB Coding Supervisor

Montgomery, AL · On-site

$34.26 - $53.96/hr

... inpatient note report, and timely charge entry to monitor departmental KPIs (i.e. weekly goals ... Required -CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist - Physician)

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Inpatient Coding Resolution Specialist information

What are some common challenges faced by inpatient coding resolution specialists, and how are they typically addressed?

Inpatient Coding Resolution Specialists often encounter challenges such as interpreting complex medical records, keeping up with frequent coding updates, and resolving discrepancies between clinical documentation and coding guidelines. To address these, specialists regularly collaborate with physicians and clinical staff to clarify documentation, participate in ongoing training to stay current with coding standards (like ICD-10 and DRG classifications), and utilize coding software to ensure accuracy. Effective communication and strong attention to detail are essential for successfully navigating these challenges within a hospital or healthcare system setting.

What is the difference between Inpatient Coding Resolution Specialist vs Medical Coder?

AspectInpatient Coding Resolution SpecialistMedical Coder
CertificationsAHIMA or AAPC credentials, coding certificationsSimilar certifications, often AHIMA or AAPC
Work EnvironmentHospitals, inpatient facilities, coding departmentsClinics, outpatient facilities, various healthcare settings
Job FocusResolving inpatient coding discrepancies, ensuring accurate DRG assignmentGeneral coding tasks across inpatient and outpatient records
Employer & Industry UsageHospitals, health systems, inpatient coding teamsMedical practices, outpatient clinics, coding companies

The Inpatient Coding Resolution Specialist primarily focuses on resolving inpatient coding issues, ensuring accurate DRG assignments, and working within hospital settings. In contrast, Medical Coders handle a broader range of coding tasks across inpatient and outpatient records. Both roles require similar certifications and often work in healthcare environments that demand precise coding skills, but their specific responsibilities and work settings differ.

What is an inpatient coding resolution specialist?

Inpatient Coding Resolution Specialists are healthcare professionals who review, analyze, and resolve discrepancies or issues in medical coding for inpatient hospital stays. They ensure that diagnoses, procedures, and services are accurately coded according to regulatory and payer requirements, which helps maximize reimbursement and maintain compliance. These specialists often collaborate with physicians, clinical staff, and other coding professionals to clarify documentation and resolve coding denials or audits. Their expertise is crucial for the financial health of healthcare organizations and for maintaining accurate patient records.

What are the key skills and qualifications needed to thrive as an inpatient coding resolution specialist?

To excel as an Inpatient Coding Resolution Specialist, you need a solid understanding of medical terminology, ICD-10-CM/PCS coding systems, and healthcare reimbursement methodologies, often backed by a certification such as CCS or RHIA/RHIT. Familiarity with electronic health record (EHR) systems, coding software, and compliance tools is crucial for accurate data entry and audit processes. Strong analytical thinking, attention to detail, and effective communication skills distinguish top performers in this role. These skills are vital to ensure coding accuracy, regulatory compliance, and optimal reimbursement for healthcare organizations.
What are popular job titles related to Inpatient Coding Resolution Specialist jobs in Alabama? For Inpatient Coding Resolution Specialist jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Inpatient Coding Resolution Specialist jobs in Alabama look for? The top searched job categories for Inpatient Coding Resolution Specialist jobs in Alabama are:
Inpatient Coding Resolution Specialist jobs near you

Coding Payment Resolution Spec

Trice Healthcare

Homewood, AL • On-site

$18.75 - $24/hr

Other

Re-posted 10 days ago

Job description

Coding Payment Resolution Specialist

Responsible for reviewing all post-billed denials (inclusive of coding-related denials) for coding accuracy and appealing them based upon coding expertise and judgment within the Hospital and/or Medical Group revenue operations of a Patient Business Services center.

Serves as part of a team of coding payment resolution colleagues at a PBS location responsible for identifying and determining root causes of denials.

Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers. In addition to promoting departmental awareness of coding best practices.

This position reports directly to the Supervisor Clinical/Coding Payment Resolution.

Essential Functions

  • Knows, understands, incorporates, and demonstrates the Client Mission, Vision, and Values in behaviors, practices, and decisions.
  • Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution.
  • Interprets data, draws conclusions, and reviews findings with all level of Payment Resolution Specialist for further review.
  • Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility.
  • Other duties as needed and assigned by the Supervisor Clinical / Coding Payment Resolution.
  • Maintains a working knowledge of applicable Federal, State and local laws/regulations; the Client and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Minimum Qualifications

  • High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred.
  • Must possess comprehensive knowledge of professional/physician diagnostic and procedural coding, as normally obtained through a coding certificate program and least one (1) year of physician/professional or hospital outpatient coding experience or minimum of two (2) years of relevant hospital inpatient coding experience including DRG assignment.
  • Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
  • Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
  • Possesses detailed understanding of principles, methods, and techniques related to compliant healthcare billing/collections.
  • Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process.
  • Must be comfortable operating in a collaborative, shared leadership environment.
  • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Client.

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