Coding Resolution Specialist III, Work from Home in Orange Park, FL at Parallon

Date Posted: 5/9/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
    Other
  • Experience:
    At least 3 year(s)
  • Date Posted:
    5/9/2018

Job Description

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

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

Job Requirements

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 highly preferred.

EXPERIENCE
1-year acute care inpatient coding experience required with 3 years’ experience preferred.

CERTIFICATE/LICENSE – RHIA, RHIT and/or CCS highly preferred.

Parallon