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 : Monday–Friday, Days (Core hours 8 : 00 AM–4 : 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 required3+ years acute care inpatient coding experience ( 5+ preferredExperience with DRG assignment (denial / appeals experience preferred)Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRGs , and inpatient coding guidelinesHigh level of accuracy, analytical ability, and communication skillsSkilled in Microsoft Office and able to work independently and meet deadlinesEducation
High school diploma / GED requiredHIM / HIT degree preferredAdditional Experience
Prior coding audit / denials experience a plusPhysical / Work Requirements
Remote work; requires sustained computer use and sittingAbility to lift up to 25 lbs occasionally