La Junta, Colorado
Posted: 10-Nov-24
Location: Altamonte Springs, Florida
Salary: Open
Categories:
Internal Number: 24039832
All the benefits and perks you need for you and your family:
· Benefits from Day One
· Career Development
· Whole Person Wellbeing Resources
· Mental Health Resources and Support
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Job Location: Monday-Friday Remote
The role you’ll contribute:
The Ambulatory Payment Classification (APC)/Edit Correction Coordinator is responsible for assigning, monitoring, and evaluating the accurate assignment of CPT and HCPCS Level II procedure codes for grouping into Ambulatory Payment Classifications (APCs) and statistical reporting. Responsible for the daily correction of outpatient account edits to ensure all facilities are receiving accurate reimbursement under OPPS. The APC/Edit Correction Coordinator assist with monthly quality reviews, RAC, and post-payment audits. Will routinely monitor the Federal Register and other sources of regulatory information to ensure the team is up to date on the latest Coding and payment updates. The APC/Edit Correction Coordinator may assist in training outpatient coders on the appropriate resolution of NCCI edits. Work alongside members of the ancillary departments and revenue cycle team to obtain timely resolution of accounts discharged but not final billed, as well as ensure we are billing clean claims. The APC/Edit Correction Coordinator will assist in the oversight of the outpatient coding queues, training and education to minimize the recurrence of account edits due to coder or charging errors
The value you’ll bring to the team:
All essential functions must be performed. Reasonable accommodations may be made to enable individuals with qualified disabilities to perform the essential functions.
1.Reviews records for ICD-10-CM, CPT and overall coding accuracy retrospectively and concurrently as assigned by manager and/or Director.
2.Responsible for daily review and resolution of accounts that populate work queues that contain claim edits, DNB edits, combines and simple visit coding validation.
3.Responsible for receiving and addressing 72-hour consecutive reviews.
4.Builds relationships with ancillary departments, revenue integrity and patient financial services to work on the timely resolution of our discharged not final coded accounts.
5.Reviews and addresses all third party/Regulatory Agencies requests for APC changes or quality studies.
6.As requested, codes and abstracts charts in accordance with ICD-10-CM conventions, applying coding rules applicable to AdventHealth, and requirements of Medicare, and payor specifications. Reviews the accounts to resolve denials requiring recoding and addition of modifiers.
7.Assign ICD-10-CM and CPT codes on chart in accordance with all UHDDS rules, ICD-10 Coding Conventions, CPT Assistant and approved coding policies and procedures.
8.Maintains 98% accuracy rate.
9.Assists manager in maintaining goals for accounts discharged not final billed.
10.Assists in reviewing and correcting any information for the Agency for Healthcare Administration (AHCA).
11.Reports non-compliance issues detected through auditing and monitoring to manager.
12.Keeps abreast of coding guidelines and reimbursement reporting requirements and brings identified concerns to manager for resolution.
13.Maintains a current knowledge of ICD-10-CM/CPT coding updates and changes through Coding Clinics and seminars, as well as changes in the Medicare/Insurance industry.
14.Uses the 3M and Dolbey CAC coding software; ICD-10-CM code books, CPA Assistant and Coding Clinics sources per established coding principals and guidelines.
15.Attends meetings as required.
16.Other duties as assigned.
The above statements reflect the general duties and responsibilities necessary to describe the principal functions of the job, as identified, and shall not be considered an exhaustive list of job responsibilities which may be inherent in the job. Responsibilities are subject to change. Attendance in accordance with the AdventHealth guidelines and policy(s) is considered an essential function of the job.
The expertise and experiences you’ll need to succeed:
EDUCATION AND EXPERIENCE: EDUCATION AND EXPERIENCE REQUIRED:
1.Minimum of 3 years' experience coding outpatient records.
2.Associate in health information or completion of a medical coding certificate program.
LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:
Please be advised that all licenses and certifications listed are not required. If you only have one or some of those listed, you may still be eligible for this position.
• Certified Coding Specialist (CCS)
• Certified Professional Coder (CPC)
• Registered Health Information Administrator (RHIA)
• Registered Health Information Technician (RHIT)
RESPONSIBILITIES:
1.Establishes and maintains courteous, tactful, and professional level of interpersonal skills necessary to deal effectively with patients, guests, medical staff, the public, co-workers and external business associates.
2.Demonstrates effective communication skills; can report and convey required information either verbally or in writing; maintains required level of confidentiality; consults with and/or advises appropriate personnel of situations requiring follow-up or attention.
3.Conforms to all Adventist Health Systems organizational and departmental policies and procedures including but not limited to:
a.Mission
b.Values/Service Standards
c.Employee covenant
d.Corporate compliance
e.Rules of conduct as outlined in the 'Guidelines for Employees' handbook.
f.Smoking g.Dress code
4.Establishes and maintains a history of regular attendance; makes appropriate use of PDO and observes department call-in procedures for absence; establishes and maintains punctual work habits. Exhibits timely arrival and departure and dependable time habits including meal and other breaks.
5.Supports departmental and organizational Mission through:
a.Appropriate use of resources
b.Helping team members
c.Accepting work or schedule assignments
d.Participating in process and performance improvement as require
