Coding Resolution Specialist III - WFH
Location:
Largo , Florida
Posted:
October 19, 2017
Reference:
25773-138765
Job Summary - The Coding Account Resolution Specialist-III (CARS-III) works inpatient coding related alerts/edits, predominately post initial/final coding. The CARS-III performs the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked according to the established procedures and thresholds, and communicated as appropriate.
Supervisor - Coding Manager
Supervises - N/A
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 daily following established procedures and thresholds
• 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
• Assigns interim DRGs for in-house patients at month end
• Completes MOCK abstracts as necessary (e.g., combining the codes for outpatient and inpatient claims subject to the payment window)
• Assists the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)
• Communicates coding revisions to the applicable party (e.g., CIS, lead, manager, international log)
• 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
• As needed, may periodically be asked to perform Coding Integrity Specialist III (CIS-III) duties
• 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
Qualifications:
KNOWLEDGE, SKILLS & ABILITIES
• Coding Technical Skills - ICD-10-CM, ICD-10-PCS, MS-DRGs, APR DRGs 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.
EDUCATION
High School graduate or GED equivalent required, undergraduate (associate or bachelors) degree in HIM/HIT preferred.
EXPERIENCE
1-year acute care inpatient coding experience required with 3 years' experience preferred.
CERTIFICATE/LICENSE - RHIA, RHIT and/or CCS preferred.
PHYSICAL DEMANDS/WORKING CONDITIONS
Position requires prolonged sitting/standing, some bending, stooping, walking and stretching. Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment. Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports or other information. Requires lifting papers/boxes and pushing/pulling up to 25 pounds occasionally. Work is performed in an office environment or hospital setting. Work may be stressful at times. Contact may involve dealing with angry or upset people. Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations.

Parallon
#Parallonbcom

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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

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