Performs retrospective (post–discharge/post-service) medical record quality audits to determine appellate potential of claims with denied reimbursement related to Inpatient coding data. Constructs and documents a succinct and fact-based case to support the appeal utilizing appropriate resources and medical record document(s) to support the appeal. (Resources include: AHA Official Coding and Reporting Guidelines, CMS guidelines, ICD-9-CM, ICD-10 and CPT coding). Demonstrates ability to critically think, problem solve and make independent decisions supporting the coding appellate process. Demonstrates proficiency in ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC and CC) and procedures. Provides education/feedback and coding guidance to client regarding coding cases that did not warrant appeal resolution. Demonstrates proficiency in utilization of electronic tools utilized during the medical record quality review process including but not limited to application of coding guidelines; patient accounting application; work listing application; visual imaging/scanning application; payor websites, electronic medical record, following Client’s training of Assigned Personnel: Client's system ACE, Invision, Star, Meditech, EPIC, MedAssets (formerly IMaCs), eCARE, Authorization log, InterQual®, VI, HPF, as well as competency in Microsoft Office. Demonstrates basic patient accounting knowledge, i.e., UB04and EOB components, adjustments, credits, debits, balance due, patient liability, etc. Serves as a resource to non-coding personnel by responding to clinical team questions/consults if needed. Provides CRC leadership with sound solutions related to process improvement. Assist in development of policy and procedures as business needs dictate. Responds to requests from clients, including legal counsel related to completed medical record reviews. Will write the appeal letter (and electronically transmit the letter) in the appropriate host system: ACE, Invision, Star, Meditech, EPIC, MedAssets, or others as may be applicable. Inventory will be assigned electronically in Client’s system “ACE” or other electronic queue or workbook. Education/Experience 3+ years’ comprehensive healthcare coding and abstracting of government and non-government payers for inpatient and outpatient records preferred. 3+ years’ comprehensive healthcare coding/documentation auditing experience or equivalent preferred. 3+ years’ experience with encoders and computerized abstracting systems preferred. Required: Bachelors or Associates degree HIM discipline or equivalent. Required: RHIA, RHIT and/or CCS; dual credential preferred. System experience: 3M 360, Cerner, Epic