Location
Lake Success
Job Type
Full-time
Posted
July 02, 2026
Job Description
**Req Number** 179272
Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing.
Highly Preferred: Auditing experience with DRGs.
Job Description
Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps.
Job Responsibility
+ Supports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers.
+ Reports program performance and/or corrective action to management on regular basis.
+ Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings.
+ Addresses coding issues and knowledge gaps; functions as a organization res...
Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing.
Highly Preferred: Auditing experience with DRGs.
Job Description
Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps.
Job Responsibility
+ Supports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers.
+ Reports program performance and/or corrective action to management on regular basis.
+ Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings.
+ Addresses coding issues and knowledge gaps; functions as a organization res...