Coding Account Resolution Specialist II - Work From Home
Company: Hospital Corporation of America
Location: Richmond, Virginia
Posted: November 19, 2017
Reference ID: 25771-140969
Parallon is seeking a Part-Time Coding Account Resolution Specialist II to Work From Home through our Richmond Shared Services Center.
Job Summary - 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.
Duties (included but not limited to):
• 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
o Same Day Surgery (SDC)
o Observation (OBV)
o Wound Care
o Outpatient Cardiac Cath
o 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)
• 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 requirements 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
Knowledge, Skills & Abilities:
• Coding Technical Skills - ICD-10-CM, CPT/HCPCS, and associated reimbursement knowledge.
• Customer Orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Policies and Procedures - articulates knowledge and understanding of organizational policies, procedures and systems.
• Quality Orientation - accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time.
• Building and Maintaining Strategic Working Relationships - develops collaborate relationships to facilitate the accomplishment of work goals. Possesses good interpersonal skills in building, negotiating, and maintaining crucial relationships.
• Initiative - independently takes prompt proactive steps towards problem resolution.
• Effective Decision Making - relating and comparing; securing relevant information and identifying key issues; committing to an action after developing courses of action that take into consideration resources, constraints, and organizational values.
• Analytical Skills - effective evaluation, synthesis and use of information gathered.
• Managing Conflict - dealing effectively with others in an antagonistic situation; using appropriate interpersonal styles and methods to reduce tension or conflict between two or more people.
• Organization - establishing courses of action to ensure that work is completed efficiently; proactively prioritizes assignments and keen ability to multi-task.
• Communication - communicates clearly, proactively and concisely with all key stakeholders.
• Customer orientation - establishes and maintains long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.
• Work Independently - is self-supporting; not needing to rely on others to complete a job.
• PC Skills - demonstrates proficiency in Microsoft Office applications and others as required.
High School graduate or GED equivalent required, 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
Certificate/ License - RHIA, RHIT and/or CCS preferred