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Coding Account Resolution Specialist II WFH in Nashville at Parallon

Date Posted: 6/1/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Nashville
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    6/1/2019

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why, after more than a decade, we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.

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
• 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

Job Requirements

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. 

EDUCATION 
• High School graduate or GED equivalent required. 
• Undergraduate (associates or bachelors) degree in HIM/HIT preferred.

EXPERIENCE
• One (1) year acute care observation and/or same day surgery hospital outpatient coding experience required.

CERTIFICATE/LICENSE 
• RHIA, RHIT and/or CCS preferred