Coding Compliance Coordinator – Health Information Management – Maitland
Maitland seeks to hire Coding Compliance Coordinator who will embrace our mission to extend the healing ministry of Christ.
Established in 1908, AdventHealth is one of the largest not-for-profit healthcare systems in the country, caring for more than a million patients each year. The Maitland Office Plaza houses our highly skilled teams that support our hospital system including Marketing, Patient Financial Services, Revenue Management, the Credit Union and Human Resources. The Trickel Building, a two-story office structure, creates an atmosphere of health and healing, with a healthy-style café and quaint chapel. The main lobby is filled with lush greenery and a light trickle of water, creating a holistic environment.
Mon – Fri / 8a – 5p
The Coding Compliance Coordinator, under general supervision by the Coding Quality Manager, is responsible for providing pre-certification coding information needed for both inpatient and outpatient encounters. Evaluates denials to determine root cause and creates processes to ensure future denial avoidance. Assists with education of all coders and Medical Staff members, while educating throughout the organization as needed. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
Licensure, Certification, or Registration Required:
RHIA – Registered Health Information Administrator certification, OR
RHIT – Registered Health Information Technician certification, OR
CCS – Certified Coding Specialist certification
Demonstrates through behavior Florida Hospital's Core Values of Integrity, Compassion, Balance, Excellence, Stewardship and Teamwork as outlined in the organization's Performance Excellence Program
Collaborates with the pre-certification and denial prevention team to provide coded information required for pre-certification of patient encounters while ensuring all coding policies, official coding guidelines, coding clinic, CPT assistant and Coding clinic for HCPCS are followed.
Obtains documentation from physician office that may be needed to ensure accuracy of codes provided following all applicable coding policies, official coding guidelines, coding clinic, CPT assistant and Coding Clinic for HCPCS. Examines and ensures that compliance is being followed according to the guidelines set for denial prevention.
Maintains active knowledge of current CCI edits and educates clinical departments concerning proper charging.
Provides continuing education to individual coders and to the coding staff concerning changes in the coding and reimbursement system as well as any area of weakness identified during the performance of coding validation reviews. Interprets and clarifies standards to staff.
Assists with writing compelling appeals to outside agencies referencing Official Coding Guidelines, Coding Clinic, CPT assistant and Coding Clinic for HCPCS advice as appropriate to defend code assignment.
Uses critical thinking and sound judgment in decision making; keeping reimbursement considerations in balance with regulatory compliance.
Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management.
Monitors the status of the unbilled reports and corrects errors to ensure the coding process is completed in a timely manner.
Evaluates outpatient surgery schedule to determine appropriate patient placement and provides APC information to various departments.
Assists with departmental outpatient coding validation reviews and preparation of statistical reports.
Assumes personal responsibility for professional growth, development and continuing education to maintain an elevated level of proficiency.
Maintains the confidentiality of employees, patients, administrative and medical staff information with no infractions.
Performs other duties as assigned.
If you want to be a part of a team that is dedicated to delivering the highest quality in patient care, we invite you to explore the Coding Compliance Coordinator opportunity with Maitland and apply online today.
We are one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.