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Ensemble Health Partners

End-to-end revenue cycle management for hospitals

Acute Coding Appeals Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeRemote in USA

About the Job

Requirements

  • Previous inpatient facility coding experience, including working appeals, denials, and edits.
  • At least 5 years of coding experience.
  • Advanced knowledge of medical coding and billing systems, documentation, and regulatory requirements.
  • Must be inquisitive and open to innovation, including artificial intelligence, to explore better processes and improve patient and client experiences.
  • Must be willing and able to travel to and work onsite at client, temporary, or corporate office locations as business needs require.
  • Minimum education: High School Diploma or GED.
  • Must hold an active coding certification, such as RHIA, RHIT, CCS, CIC, CPC, or COC.
  • Must reside and be authorized to work within the United States.

Responsibilities

  • Integrate medical coding principles and objectivity into coding appeals and denials activities, using ICD-10-CM, ICD-10-PCS, HCPCS, NCCI, CMS, and CMG expertise to identify potential billing or coding issues and quality concerns.
  • Participate in client system education to learn what is needed to appeal client accounts and ensure coding is supported by patient clinical documentation, coding and CDI guidelines, and applicable regulatory standards and guidelines.
  • Maintain detailed documentation, spreadsheets, account information, and claim examples of root-cause issues.
  • Search governmental, payer-specific, hospital-specific, regulatory-body, and literature rules, regulations, and guidelines to identify coding and billing requirements and make recommendations to clients.
  • Assist in education and training for the client coding companion regarding coding appeals outcomes.
  • Meet established productivity standards for coding appeals and coding certification requirements.
  • Attend in-house sessions to receive updated coding information and changes in coding or regulations.
  • Provide customer service in an organized and efficient manner while maintaining a positive attitude.
  • Review and write appeals for inpatient Diagnosis Related Group denials to support the assigned DRG and address the clinical documentation used to validate the assigned codes.

About the Company

Ensemble Health Partners

End-to-end revenue cycle management for hospitals

Ensemble Health Partners provides end-to-end revenue cycle management for hospitals and health systems. It handles the entire process from patient intake to final payment, with teams and technology embedded into the provider's operations and a revenue model tied to performance improvements. The company uses its proprietary EIQ platform (analytics, AI, and workflow automation) to optimize revenue cycle processes, reduce insurance denials, and speed cash collection, managing more than $39 billion in net patient revenue. Its approach differentiates it by being a true managed-services partner with full accountability for financial outcomes and a track record of meeting initial client goals. The overarching goal is to improve healthcare providers’ financial performance so they can focus on patient care.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Cincinnati, OH
Founded
2014

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