DRG Appeals Writer Position Available In DeKalb, Georgia

DRG Appeals Writer Piedmont Healthcare – 3.6

Atlanta, GA Job Details Full-time Estimated:

$53.3K – $74.8K a year 1 day ago Qualifications Microsoft Word Microsoft Excel Inpatient RHIA 5 years Medical coding Writing skills AHIMA Financial software RHIT Master’s degree Certified Professional Coder

ICD-9 ICD-10

Bachelor’s degree Certified Coding Associate Case management Certified Coding Specialist Epic Senior level

DRG Full Job Description DRG Appeals Writer Description:

RESPONSIBLE FOR

The individual in this position on behalf of the entire Piedmont System will be responsible for managing the administrative appeal of reimbursement claims denied by Medicare or Medicaid on the grounds that the medical coding was incorrect. These duties involve coordination of activities with the managers of coding at each of the Piedmont affiliated hospitals and physician practices as well as the Senior Director of Government Appeals. The incumbent must maintain a high level of understanding of DRGs and MS/DRGs.

ICD-9-CM

Official Guidelines for Coding and Reporting, American Hospital Association Coding Clinic guidelines, federal guidelines for coding Medicare inpatient records, state guidelines for coding Medicaid records, Utilization Review (UR) regulations and Medicare guidelines regarding medical necessity, inpatient, outpatient and observation. In the context of managing the appeals, the incumbent will be responsible for resolving differences of opinions among coders as to the most appropriate code. The incumbent will be responsible for preparing the coding appeals; performing a detailed review, analysis and extraction of clinical and coding information from patient medical records and drafting effective narratives for Medicare and Medicaid appeals briefs in support of denied cases throughout appeals at all levels of the government appeals process. In addition, the incumbent will be qualified and available to testify in appeal hearing before an administrative law judge as an expert in medical coding.

REMOTE/WORK FROM HOME SCHEDULE

MONDAY-FRIDAY, FLEXIBLE HOURS Qualifications:

MINIMUM EDUCATION REQUIRED

Bachelor’s degree required. In lieu of degree, six (6) years of relevant work experience will be accepted in addition to the experience requirement.

MINIMUM EXPERIENCE REQUIRED

Five (5) years of inpatient coding experience and of

DRG-MS/DRG

auditing experience in a healthcare setting. Experienced medical record/DRG coder/auditor with a working knowledge of ICD-10 guidelines, case management, government and contracted payers. Must be experienced in clinical, coding and patient financial services software such as 3-M Encoder, SCM / Quest, STAR, EPIC, Client Tracking, and I-Suites. (If no degree, a total of eleven (11) years of experience required).

MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW

None.

ADDITIONAL QUALIFICATIONS

One or more certifications required – Registered Health Information Management Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), CCA, CCS-P, CPC, CPC-H. Coding Certificate program (AHIMA accredited) preferred. Experience in coding at a multi-facility organization and remote coding experience is a plus. Master’s degree and previous experience writing DRG Appeals preferred. Previous experience with RAC claims denials preferred. Microsoft Word and Excel proficiency preferred. HealthPort AudaPro systems experience a plus. Position Information

LOCATION

Atlanta, Georgia

POSTED 06/19/2025 TYPE

Revenue Cycle

SCHEDULE

Full-time SHIFT Day Job JOB ID 1900436