Coding Appeals Specialist – Hospital Billing

Join Tri Health as a Coding Appeals Specialist – Hospital Billing!

Tri Health offers Coding Denials Specialists the opportunity to make a meaningful impact by protecting revenue, reducing financial loss, and ensuring accurate, compliant coding practices across the organization. In this role, you'll apply your expertise in ICD-9, ICD-10, DRG, CPT, CDI, and hospital billing to resolve complex denials, collaborate with payers, and craft effective appeals that support maximum reimbursement. You'll serve as a trusted resource to billing teams and internal partners, helping them navigate coding issues, interpret regulations, and maintain standardized, high-quality coding and billing procedures.

As one of Cincinnati's most respected healthcare employers, Tri Health provides a supportive, collaborative environment where your technical knowledge and problem-solving skills are valued. You'll work closely with multiple departments, stay current on evolving coding guidelines, and contribute to a culture committed to accuracy, compliance, and service excellence. Tri Health invests in its people - offering stability, professional growth, and the chance to build a rewarding career while advancing the organization's mission of delivering exceptional care.

Apply today and grow your career with a team that truly values you.

Location:

Tri Health in Norwood at 4685 Forest Ave, Cincinnati, OH 45212

Work Schedule:

Full-Time (80 hours biweekly) Day Shift No Weekend, Holiday or On Call Commitment

Benefits:
In addition to a comprehensive benefits package - including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement.

Job Requirements:

Associate's Degree in Coding RHIT (Associates) (Required) 3 - 4 years experience in related field (Required) Billing/Payer knowledge of hospital billing Must be familiar and experienced with CDI. ICD-9, ICD-10, DRG CPT Coding guidelines Medical terminology Physiology Other Insurance ertified Pension Consultant (CPC) Upon Hire Required Other CCS-Certified Coding Specialist Upon Hire Required Other CMC
- Cardiac Medicine-Subspecialty Certification Upon Hire Required Other CCA
- Certified Coding Associate Upon Hire Required

Job Overview:
Principal purpose is to expedite hospital coding denials to ensure maximum reimbursement and to reduce/eliminate financial loss to department customers. Contact payers regarding coding issues and using appeal letters to reduce fatal denials. Provides coding expertise to billing teams to assist in proper billing

Job Responsibilities:

Assists with billing/coding questions from both internal and external customers which include, following up on denials, review of charts and coding issues. Backs up for team members within Payroll and all other special assignments from Payroll Director. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance carriers, and other resources. Maintains a close working relationship with all departments and consolidates efforts to ensure appropriate and standardized coding/billing procedures are followed.

Maintains knowledge of current coding revisions. Resolves coding issues that arise within the patient accounting departments and provides coding support. Works directly with the billing teams to ensure denials for coding are appealed and followed up on appropriately, and in a timely manner.

Working Conditions:

Climbing
- Rarely Concentrating
- Consistently Continuous Learning
- Consistently Hearing:
Conversation
- Frequently Interpersonal Communication
- Frequently Kneeling
- Rarely Lifting