Coding/CDI Denials Analyst - CCDS

%3Cb%3EWHY UT SOUTHWESTERN?%3C/b%3E%3Cbr%3E%0AWith over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to %3Ca href=%22https://www.utsouthwestern.edu/newsroom/articles/year-2022/july-us-news-best-hospital.html%22 target=%22_blank%22%3EU.S. News %26 World Report%3C/a%3E, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you%27ll discover a culture of teamwork, professionalism, and a rewarding career!%0A%0A%3Cbr%3E%3Cbr%3E%3Cb%3EJOB SUMMARY%3C/b%3E%3Cbr%3E%0AThe Coding/CDI Denials Analyst primary responsibilities are to review coding denials for inpatient hospital medical records, for accuracy of assigned codes, and ensure all Official Coding Guidelines and conventions were followed. Also, to ensure the clinical evidence and provider documentation supports the assigned codes and DRG.%0ACompose and submit appeal letters as appropriate, identify coding trends/opportunities for root causes of denials, which would be relevant for additional education to individual Coders/CDI Specialist%27s and/or the entire Coding/CDI Teams. Report these trends/opportunities to the Lead Denials Analyst to ensure education is developed and provided to the Coders and/or CDI Teams. Identify and communicate front-end activities that influence the denials/appeals process, seeking opportunities for process improvement. %0A %3Cbr%3E%3Cbr%3E%3Cp%3E%3Cb%3EBENEFITS%3C/b%3E%3Cbr%3E%0AUT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:%3C/p%3E%0A%3Cul%3E%0A %3Cli%3EPPO medical plan, available day one at no cost for full-time employee-only coverage%3C/li%3E%0A %3Cli%3E100% coverage for preventive healthcare-no copay%3C/li%3E%0A %3Cli%3EPaid Time Off, available day one%3C/li%3E%0A %3Cli%3ERetirement Programs through the Teacher Retirement System of Texas (TRS)%3C/li%3E%0A %3Cli%3EPaid Parental Leave Benefit%3C/li%3E%0A %3Cli%3EWellness programs%3C/li%3E%0A %3Cli%3ETuition Reimbursement%3C/li%3E%0A %3Cli%3EPublic Service Loan Forgiveness (PSLF) Qualified Employer%3C/li%3E%0A %3Cli%3E%3Ca href=%22http://jobs.utsouthwestern.edu/benefits/#top%22 target=%22_blank%22%3ELearn more about these and other UTSW employee benefits!%3C/a%3E%0A %3C/li%3E%0A%3C/ul%3E%3Cbr%3E%3Cbr%3E%3Cb%3E%3Cb%3EEXPERIENCE AND EDUCATION%3C/b%3E%3C/b%3E%3Cbr%3E%0A%3Cbr%3E%3Cb%3ERequired%3C/b%3E%3Cul%3E%3Cb%3E%3Cli%3EExperience%3C/b%3E%3Cbr%3E3 years three to five (3-5) year%27s acute hospital-based Coding and/or CDI experience or %3Cbr%3E%0A An equivalent combination of education and experience may be considered %3Cbr%3E%0A Denials and Appeals experience in an acute Hospital setting and %3Cbr%3E%0A Experience working in a remote environment %3Cbr%3E%3C/ul%3E%3Cul%3E%3Cb%3E%3Cli%3ELicenses and Certifications%3C/b%3E%3Cbr%3E(RHIA) REGD HEALTH INFO ADMINIST or %3Cbr%3E%0A(RHIT) REGD HEALTH INFO TECHNOLO or %3Cbr%3E%0A(CCS) CERT CODING SPECIALIST or %3Cbr%3E%0A(CCDS) Cert Clinical Documentation or %3Cbr%3E%0A(CDIP) CERT DOCUMNTATN IMPROVMNT PRAC %3Cbr%3E%3C/ul%3E%3Cb%3EPreferred%3C/b%3E%3Cul%3E%3Cb%3E%3Cli%3EExperience%3C/b%3E%3Cbr%3E RN with CDI experience %3Cbr%3E%3C/ul%3E%3Cbr%3E%3Cb%3E%3Cb%3EJOB DUTIES%3C/b%3E%3C/b%3E%3Cul%3E %3Cli%3EReview coding and/or clinical denials, ensuring all coding guidelines and conventions were followed, and ensuring all clinical evidence and provider documentation supports the assigned codes and DRG. %3C/li%3E%0A%3Cli%3ECompose an effective appeal utilizing appropriate coding guidelines, relevant and effective clinical documentation, current industry guidelines, evidence-based medicine, and local and national medical management standards and protocols. %3C/li%3E%0A%3Cli%3EIdentify coding and/or documentation trends for root causes of denials. %3C/li%3E%0A%3Cli%3EIdentify and communicate DRG changes and financial impact. %3C/li%3E%0A%3Cli%3EIdentify coding and clinical educational opportunities and report these to the Lead Denials Analyst. %3C/li%3E%0A%3Cli%3EIdentify front-end activities that influence denial/appeals process. %3C/li%3E%0A%3Cli%3ESupport the Quality Standards set by UTSW and the HIM Coding %26amp; CDI Department. %3C/li%3E%0A%3Cli%3EMaintains an expert level of knowledge of Coding/CDI guidelines and practices. %3C/li%3E%0A%3Cli%3EOther duties as assigned. %3C/li%3E %0A%3Cbr%3E%3C/ul%3E%3Cb%3E%3Cb%3ESECURITY AND EEO STATEMENT%3C/b%3E%3C/b%3E%3Cbr%3E%3Cbr%3E%3Cb%3ESecurity%3C/b%3E%3Cbr%3EThis position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.%3Cbr%3E%3Cbr%3E%3Cb%3EEEO%3C/b%3E%3Cbr%3E%0AUT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.%3C/br%3E