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
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom