Coding Account Resolution Specialist-Outpatient

HCA•Nashville, TN

58d

About The Position

The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate. What you will do in this role:

Requirements

High School graduate or GED equivalent preferred, undergraduate (associates or bachelors) degree in HIM/HIT preferred
One (1) year acute care observation and/or same day surgery hospital outpatient coding experience required

Nice To Haves

RHIA, RHIT and/or CCS preferred

Responsibilities

Compiles daily work list from eRequest, CRT and/or other alert/edit systems
Takes action and resolves alerts/edits for the following patient types following established procedures and thresholds
Same Day Surgery (SDC)
Observation (OBV)
Wound Care
Outpatient Cardiac Cath
Provides back up/coverage as needed for:
Emergency Dept (ED)
Recurring (RCR)
Clinical (CLI)
Provider Office Visit (POV), as applicable
Enters detailed notes to update eRequest to provide details if the alert/edit cannot be resolved or must be rerouted to another responsible party for research/resolution
Escalates alert/edit resolution issues as appropriate to minimize final billing delays
Monitors the aging of accounts held by an alert/edit, prioritizes aged accounts first, and reports to leadership
Works with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits
Communicates coding revisions to the applicable party (e.g., CIS, lead, manager, international log)
Completes MOCK abstracts as necessary (e.g., combining the codes for outpatient claims subject to the payment window)
Assists the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons
As needed, may periodically be asked to perform Coding Integrity Specialist II (CIS-II) duties
Periodically works with their Manager to review individual work accomplishments, discuss work problems/barriers, discuss progress in mastering tasks and work processes, and discusses individual training needs and career progression
Adheres to all applicable coding and billing regulations and guidance, including but not limited to, CMS, AHA and HCA policies and guidelines
Meets all educational requirement as stated in Company and HSC policy
Reviews all official data quality standards, coding guidelines, Company policies and procedures and clinical/medical resources to assure coding knowledge and skills remain current
Practice and adhere to the Company's Code of Conduct philosophy
Practice and adhere to the Company's Mission and Values
Other duties as assigned

Benefits

Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.