Ambulatory Payment Classification Coordinator
About The Position
The Ambulatory Payment Classification (APC) Coordinator is responsible for assigning, monitoring, and evaluating the assignment of CPT and HCPCS Level II procedure codes for grouping into Ambulatory Payment Classifications (APCs) and statistical reporting. Responsible for monitoring the outpatient APC reimbursement for all AdventHealth Central Florida South Division facilities. Monitoring and resolving APC edits to ensure all facilities are receiving accurate reimbursement under OPPS. The APC Coordinator may 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 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 a timely resolution of accounts discharged but not final billed and ensure we are billing clean claims. The APC Coordinator will assist in overseeing the outpatient coding queues, training, and education.
Requirements
- High School Grad or Equiv Required
- 3 Work Experience Required
- Registered Health Information Administrator (RHIA)
- Registered Health Information Technician (RHIT) - Cert Required
- Certified Professional Coder (CPC)
- Certified Coding Specialist (CCS)
Responsibilities
- Conducts retrospective and concurrent coding accuracy reviews as assigned by the supervisor, manager, and/or director.
- Reviews and resolves accounts in work queues, including claim edits, Discharged Not Billed (DNB) edits, combined accounts, and simple visit coding validations.
- Builds and maintains collaborative relationships with ancillary departments, Revenue Integrity, and Patient Financial Services to support the timely resolution of Discharged Not Final Coded (DNFC) accounts.
- Reviews and responds to third-party and regulatory agency requests, including quality studies and audit findings.
Benefits
- Benefits from Day One
- Paid Days Off from Day One
- Career Development
- Whole Person Wellbeing Resources
- Mental Health Resources and Support
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Industry
Ambulatory Health Care Services
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
