Posted: Sep 18, 2020
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Specialist, DRG Denials & Appeals

NYU Winthrop Hospital - Mineola, NY
Full-time
Salary: Annually
Application Deadline: N/A

NYU Winthrop is a 591-bed university-affiliated medical center, which offers sophisticated diagnostic and therapeutic care in virtually every specialty and subspecialty of medicine and surgery. We are a major regional healthcare resource with a deep commitment to medical education and research, offering a full complement of inpatient and outpatient services.

We have an exciting opportunity to join our team as a Specialist, DRG Denials & Appeals.

In this role, the successful candidate analyzes and responds to DRG Denials for NYU Winthrop Hospital. Formulates timely written appeal responses to Third Party Payors, RAC, and all other DRG payment denials based on expertise in Clinical Validation and Coding practices as outlined by AHIMA, ACDIS, AHA, coding Clinic, the AMA, CMS, UHDDS Data Element Definitions, and Evidence-based Practice Literature. Assists with the development and maintenance of Policies and Procedures relating to the Denials Process. Maintains metrics of Denial trends for reporting purposes and for use as an educational tool for Coder and Clinical Documentation Improvement education and training.

Qualifications:

  • A Bachelor’s degree in Nursing or other health related field or Health Information Management.
  • 3-5 years of Coding and Clinical Validation experience, acute care hospital experience in medical record chart review and current experience with reimbursement methodologies.
    Certified Coding Specialist Certification (CCS).
    Demonstrates and maintains ongoing responsibility for professional development.
    Ability and willingness to work a flexible schedule to ensure compliance with deadlines.
    Strong communication (verbal and written) and interpersonal skills.
    Demonstrates critical thinking and analytical skills.
    Ability to work collaboratively in a team environment.
    Demonstrates the ability to handle multiple assignments and carry out work independently with minimal supervision.
    Proficient with Microsoft applications and working knowledge of EPIC and other hospital based clinical computer systems.
  • Must be able to effectively communicate with all levels of the organization.

Experience preparing appeals for DRG Denials and Certification in Clinical Documentation Improvement preferred.

NYU Winthrop provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you’ll feel good about devoting your time and your talents.

NYU Winthrop is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online.