Work whereevery momentmattersEvery day approximately Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemJOB SUMMARYThe Denials Specialist is responsible for HIM Coding denial resolution and prevention activities consistent with regulatory and healthcare revenue cycle industry standards Communicates and educates on any identified coding denial trendsJOB RESPONSIBILITIESDenials ResolutionWorks with coding staff to investigate and resolve coding related denialsConducts account research and works with others as needed to determine the appropriate course of denial appealsCollaborates with clinical staff andor outside providers to obtain further information to be used in the coding and appeals processCreates written appeals utilizing official coding guidelines coding clinic and CPT assistant or other resources as appropriateAssists with processing HIM Coding validation denial and audit finding letters to third party vendor HROIMonitors and follows up on appeals to ensure appeal has resulted in an overturned denial or has escalated through the proper channelsMeets revenue cycle goals Key Performance Indicators KPIs and Productivity StandardsDenials PreventionIdentifies complex denial coding issues adversely impacting the HIM Coding team and communicates findings to ManagerEducationProvides education and training on identified coding denial trends and recommended remediationCommunicationEscalates or communicates coding denials to appropriate departments per established process Coding Billing Compliance etcOtherRuns reports and analyzes coding and denials data per requests from HIM coding teams as neededParticipates in general or special assignments and other duties as assignedMentors new and existing team members on denials initiativesAbides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelinesWork whereevery momentmattersEvery day approximately Hartford HealthCare colleagues come to work with one thing in common Pride in what we do knowing every moment matters here We invite you to become part of Connecticutrsquos most comprehensive healthcare networkThe creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole rather than a single member organizationWith the creation of our new umbrella organization we now have our own identity with a unique payroll benefits performance management system service recognition programs and other common practices across the systemJOB SUMMARYThe Denials Specialist is responsible for HIM Coding denial resolution and prevention activities consistent with regulatory and healthcare revenue cycle industry standards Communicates and educates on any identified coding denial trendsJOB RESPONSIBILITIESDenials ResolutionWorks with coding staff to investigate and resolve coding related denialsConducts account research and works with others as needed to determine the appropriate course of denial appealsCollaborates with clinical staff andor outside providers to obtain further information to be used in the coding and appeals processCreates written appeals utilizing official coding guidelines coding clinic and CPT assistant or other resources as appropriateAssists with processing HIM Coding validation denial and audit finding letters to third party vendor HROIMonitors and follows up on appeals to ensure appeal has resulted in an overturned denial or has escalated through the proper channelsMeets revenue cycle goals Key Performance Indicators KPIs and Productivity StandardsDenials PreventionIdentifies complex denial coding issues adversely impacting the HIM Coding team and communicates findings to ManagerEducationProvides education and training on identified coding denial trends and recommended remediationCommunicationEscalates or communicates coding denials to appropriate departments per established process Coding Billing Compliance etcOtherRuns reports and analyzes coding and denials data per requests from HIM coding teams as neededParticipates in general or special assignments and other duties as assignedMentors new and existing team members on denials initiativesAbides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelinesREQUIREMENTS AND SPECIFICATIONSEducationAssociate Degree or equivalentExperienceTwo years of progressive on the job coding experience in an acute care hospital setting requiredOne year denials review auditing management andor coder training experienceLicensure Certification RegistrationCertified Coding specialist CCS andor Certified Procedural Coder CPCLanguage SkillsStrong written and verbal communication skillsKnowledge Skills and Ability RequirementsComprehensive understanding of ICD CM diagnosis and ICD PCS andor CPTHCPCUnderstands the Uniform Hospital Discharge Data Set UHDDSUnderstands DRGs APCs andor Outpatient Code Edits OCE and Correct Coding Initiative CCI editsIRF PAI IP RehabilitationWorking knowledge of clinical informationExtensive knowledge of state federal and Medicare regulations related to codingBasic knowledge of the revenue cycle for the purpose of communicating corrective action recommendationsMicrosoft Office Products Word ExcelEncoder andor Computer Assistant Coding CACHROI and CobiusStrong analytical capabilitiesStrong organizational skillsStrong critical thinking problem solving and deductive reasoning skillsAbility toFunction independentlyHandle multiple prioritiesListen and acknowledge ideas and expressions of others attentivelyConverses clearly using appropriate verbal and written communications as well as convey positive body languageCollaborate with others to achieve a common goal through mutual cooperationInfluence others for positive and productive outcomesWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour momentREQUIREMENTS AND SPECIFICATIONSEducationAssociate Degree or equivalentExperienceTwo years of progressive on the job coding experience in an acute care hospital setting requiredOne year denials review auditing management andor coder training experienceLicensure Certification RegistrationCertified Coding specialist CCS andor Certified Procedural Coder CPCLanguage SkillsStrong written and verbal communication skillsKnowledge Skills and Ability RequirementsComprehensive understanding of ICD CM diagnosis and ICD PCS andor CPTHCPCUnderstands the Uniform Hospital Discharge Data Set UHDDSUnderstands DRGs APCs andor Outpatient Code Edits OCE and Correct Coding Initiative CCI editsIRF PAI IP RehabilitationWorking knowledge of clinical informationExtensive knowledge of state federal and Medicare regulations related to codingBasic knowledge of the revenue cycle for the purpose of communicating corrective action recommendationsMicrosoft Office Products Word ExcelEncoder andor Computer Assistant Coding CACHROI and CobiusStrong analytical capabilitiesStrong organizational skillsStrong critical thinking problem solving and deductive reasoning skillsAbility toFunction independentlyHandle multiple prioritiesListen and acknowledge ideas and expressions of others attentivelyConverses clearly using appropriate verbal and written communications as well as convey positive body languageCollaborate with others to achieve a common goal through mutual cooperationInfluence others for positive and productive outcomesWe take great care of careersWith locations around the state Hartford HealthCare offers exciting opportunities for career development and growth Here you are part of an organization on the cutting edge ndash helping to bring new technologies breakthrough treatments and community education to countless men women and children We know that a thriving organization starts with thriving employees we provide a competitive benefits program designed to ensure worklife balance Every moment matters And this isyour moment