Inpatient Coding Resolution Specialist

HCA Healthcare•Nashville, TN

About The Position

The Coding Account Resolution Specialist-III (CARS-III) works inpatient coding-related alerts and edits, predominantly after initial and final coding. The specialist resolves alerts and edits in applicable systems according to established procedures and thresholds, documenting and communicating issues as appropriate. The role helps minimize final billing delays by monitoring held accounts, prioritizing aged accounts, escalating issues, and working with billing, revenue integrity, and Medicare Service Center colleagues. The specialist may also perform Coding Integrity Specialist III duties as needed and must keep coding knowledge current while adhering to applicable regulations, guidelines, company policies, and the Company’s Code of Conduct, Mission, and Values.

Requirements

At least 1 year of acute care inpatient coding experience is required.
High school graduate or GED equivalent preferred.
Must meet all educational requirements stated in Company and HSC policy.

Nice To Haves

Three years of experience preferred.
Undergraduate degree in HIM/HIT (associate or bachelor’s) preferred.
RHIA, RHIT, and/or CCS credential preferred.

Responsibilities

Compile daily work lists from eRequest, CRT, and/or other alert/edit systems.
Take action to resolve alerts and edits daily according to established procedures and thresholds.
Enter detailed notes in eRequest when an alert/edit cannot be resolved or must be rerouted for research or resolution.
Escalate alert/edit resolution issues as appropriate to minimize final billing delays.
Monitor the aging of accounts held by an alert/edit, prioritize aged accounts, and report to leadership.
Work with team members in billing, revenue integrity, and/or the Medicare Service Center to resolve alerts and edits.
Assign interim DRGs for in-house patients at month end.
Complete MOCK abstracts as necessary, such as combining codes for outpatient and inpatient claims subject to the payment window.
Assist Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC) and hold reasons.
Communicate coding revisions to the applicable party, such as CIS, a lead, a manager, or the international log.
Periodically review work accomplishments, work problems and barriers, progress in mastering tasks and processes, training needs, and career progression with the Manager.
Adhere to applicable coding and billing regulations and guidance, including CMS, AHA, and HCA policies and guidelines.
Perform Coding Integrity Specialist III duties periodically as needed.
Review official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to keep coding knowledge and skills current.
Practice and adhere to the Company’s Code of Conduct philosophy, Mission, and Values.
Perform other duties as assigned.

Benefits

Comprehensive medical, prescription drug, dental, vision, behavioral health, and telemedicine benefits.
Free counseling and referral services.
Paid time off, paid family leave, long- and short-term disability coverage, and leaves of absence.
401(k) plan with a 100% match on 3% to 9% of pay, based on years of service.
Employee Stock Purchase Plan and flexible spending accounts.
Preferred banking partnerships, retirement readiness tools, rollover support, and financial wellbeing counseling.
Tuition assistance, student loan assistance, certification support, dependent scholarships, and a partnership with Galen College of Nursing.
Fertility and family-building benefits and adoption assistance.
Life insurance and supplemental health protection plans.
Auto and home insurance, legal counseling, identity theft protection, and consumer discounts.