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Coding Denials Managemet Specialist (HIM Inpatient), Senior - HIM Financial - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
In accordance with current federal & state coding compliance regulations and guidelines, the HIM Coding Denials Management Specialist" analyze, investigate, mitigate, and resolve all coding-related 'claims denials' and 'claims rejections,' specific to ICD-10-CM, ICD-10-PCS, CPT/HCPCS, DRGs, APCs, and Modifiersfrom Medicare, Medi-Cal, MAC, RAC, and commercial insurance companies when there is refusal or rejection to honor Keck Medicine of USC request for payment for both IP & OP healthcare services provided to covered patients. Manages the denial management process for coding-related denials, triage denied claims to distinguish coding-related denials versus clinical-related denials, evaluating claims deemed inappropriately paid by the payer/external auditors, and determining the need for
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