Job Information
Robert Half Inpatient Medical Coder in Minneapolis, Minnesota
Description
The Acute Coding Appeals Specialist reviews and writes appeals for inpatient DRG denials to support accurate code assignment and reimbursement. This role applies advanced ICD-10, DRG, CMS, and payer-specific knowledge to defend coding decisions, ensure compliance, and address billing and documentation concerns.
Key Responsibilities
Review inpatient DRG denials and draft well-supported appeal letters using ICD-10-CM/PCS, HCPCS, NCCI, CMS, and CMG guidelines.
Analyze clinical documentation to validate the originally assigned DRG and ensure compliance with regulatory standards.
Research payer policies, government regulations, and industry guidelines to strengthen appeal arguments.
Maintain detailed documentation, tracking spreadsheets, and root cause analyses for denial trends.
Collaborate with client coding and CDI teams to provide education based on appeal outcomes.
Meet established productivity and quality standards while maintaining coding certification requirements.
Stay current on coding updates, regulatory changes, and reimbursement rules.
Deliver professional, organized, and customer-focused communication with clients.
Requirements
5+ years of inpatient facility coding experience (required).
Experience handling appeals, denials, and claim edits.
Advanced knowledge of coding systems, billing processes, and regulatory standards.
Strong research, analytical, and written communication skills.
Ability to track trends and identify root cause issues.
Education & Certification
High School Diploma or GED (minimum).
Active coding certification required (RHIA, RHIT, CCS, CIC, CPC, COC, etc.).
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