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Overview: The individual in this position on behalf of the entire Piedmont System will be responsible for managing the administrative appeal of reimbursement claims denied by Medicare or Medicaid on the grounds that the medical coding was incorrect. These duties involve coordination of activities with the managers of coding at each of the Piedmont affiliated hospitals and physician practices as well as the Senior Director of Government Appeals. The incumbent must maintain a high level of understanding of DRGs and MS/DRGs. ICD-9-CM Official Guidelines for Coding and Reporting, American Hospital Association Coding Clinic guidelines, federal guidelines for coding Medicare inpatient records, state guidelines for coding Medicaid records, Utilization Review ("UR") regulations and Medicare guidelines regarding medical necessity, inpatient, outpatient and observation. In the context of managing the appeals, the...