Coding and Claim Edit Resolution Specialist

Our promise to you:

Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

All the benefits and perks you need for you and your family:

• Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance

• Paid Time Off from Day One

• 403-B Retirement Plan

• 4 Weeks 100% Paid Parental Leave

• Career Development

• Whole Person Well-being Resources

• Mental Health Resources and Support

• Pet Benefits

Schedule:

Full time

Shift:

Day (United States of America)

Address:

900 WINDERLEY PL

City:

MAITLAND

State:

Florida

Postal Code:

32751

Job Description:

Schedule: Full Time

Shift: Days

Conducts retrospective and concurrent coding accuracy reviews as assigned by the supervisor, manager, and/or director.

Reviews and resolves accounts in work queues, including claim edits, Discharged Not Billed (DNB) edits, combined accounts, and simple visit coding validations.

Builds and maintains collaborative relationships with ancillary departments, Revenue Integrity, and Patient Financial Services to support the timely resolution of Discharged Not Final Coded (DNFC) accounts.

Reviews and responds to third-party and regulatory agency requests, including quality studies and audit findings.

Codes and abstracts medical records as requested, in accordance with ICD-10-CM conventions, AdventHealth coding policies, and applicable Medicare and payer guidelines; addresses denials and applies necessary modifiers.

Experience in both inpatient and outpatient facility coding, including ICD-10-CM and CPT, is required.

Knowledge, Skills, and Abilities:
• Excellent communication skills required, with the ability to articulate and communicate information in understandable terms to all levels of staff.
• Progressive professional growth required.
• Exhaustive knowledge of outpatient coding and working knowledge of ICD-10-CM, CPT, NCCI edits, and all regulatory compliance requirements required.
• A solid understanding of Medicare coding and billing requirements for hospital services required.
• Strong organizational skills required.
• Ability to work in a remote environment to achieve organizational goals required.
• Computer proficiency required, in Microsoft Office Outlook, Word, Excel, and Teams.
• Knowledge and understanding of coding guidelines and standards required.
• Proficiency in Microsoft computer applications specifically Excel, Teams, and PowerPoint preferred.

Education:
• Associate [Preferred]• Bachelor’s [Preferred]• High School Grad or Equiv [Required]

Field of Study:
• or equivalent technical or military training.

Work Experience:
• 3+ acute care facility coding with icd-10-cm and cpt coding. [Required]

Additional Information:
• N/A

Licenses and Certifications:
• Registered Health Information Administrator (RHIA) [Required] OR
• Registered Health Information Technician (RHIT) [Required] OR
• Certified Professional Coder (CPC) [Required] OR
• Certified Coding Specialist (CCS) [Required]

Physical Requirements: (Please click the link below to view work requirements)
Physical Requirements – https://tinyurl.com/23km2677

Pay Range:

$23.91 – $44.46

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.