Illinois Ambulatory Surgery Center AssociationIASCA

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

• Benefits from Day One
• Paid Days Off from Day One
• Career Development
• Whole Person Wellbeing Resources

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.

Schedule: Full Time;

Shift: Monday-Friday

Location: Virtual

The role you’ll contribute:

The Ambulatory Payment Classification (APC)/Edit Correction Coordinator is responsible for assigning, monitoring, and evaluating the accurate assignment of CPT and HCPCS Level II procedure codes for grouping into Ambulatory Payment Classifications (APCs) and statistical reporting. Responsible for the daily correction of outpatient account edits to ensure all facilities are receiving accurate reimbursement under OPPS.  The APC/Edit Correction Coordinator assist with monthly quality reviews, RAC and post-payment audits.  Will routinely monitor the Federal Register and other sources of regulatory information to ensure the team is up to date on the latest Coding and payment updates.  The APC/Edit Correction Coordinator may assist in training outpatient coders on the appropriate resolution of NCCI edits.  Work alongside members of the ancillary departments and revenue cycle team to obtain timely resolution of accounts discharged but not final billed as well as ensure we are billing clean claims.  The APC/Edit Correction Coordinator will assist in the oversight of the outpatient coding queues, training and education no minimize the recurrence of account edits due to coder’s or charging errors.

The value you’ll bring to the team:

All essential functions must be performed.  Reasonable accommodations may be made to enable individuals with qualified disabilities to perform the essential functions.

• Reviews records for ICD-10-CM, CPT and overall coding accuracy retrospectively and concurrently as assigned by manager and/or Director.
• Responsible for daily review and resolution of accounts that populate workqueues that contain claim edits.
• Responsible for receiving and addressing 72-hour work items.
• Builds relationships with ancillary departments, revenue integrity and patient financial services to work on the timely resolution of our discharged not final coded accounts.
• Reviews and addresses all third party/Regulatory Agencies requests for APC changes or quality studies.
• As requested, codes and abstract charts in accordance with ICD-10-CM conventions, applying coding rules applicable to AdventHealth West Florida Division and requirements of Medicare and payor specifications.  Reviews the accounts to resolve denials requiring recoding and addition of modifiers.
• Assign ICD-10-CM and CPT codes on chart in accordance with all UHDDS rules, ICD-10 Coding Conventions, CPT Assistant and approved coding policies and procedures.
• Maintains 98% accuracy rate.
• Assists manager in maintaining goals for accounts discharged not final billed.
• Assists in reviewing and correcting any information for the Agency for Healthcare Administration (AHCA).
• Reports non-compliance issues detected through auditing and monitoring to manager.
• Keeps abreast of coding guidelines and reimbursement reporting requirements and brings identified concerns to manager for resolution.
• Maintains a current knowledge of ICD-10-CM/CPT coding updates and changes through Coding Clinics and seminars, as well as changes in the Medicare/Insurance industry.
• Uses the 3M and Dolbey CAC coding software; ICD-10-CM code books, CPA Assistant and Coding Clinics sources per established coding principals and guidelines.
• Attends meetings as required.
• Other duties as assigned.

The expertise and experiences you’ll need to succeed:

Minimum qualifications:

• Minimum of 3 years’ experience coding outpatient records.
• RHIA or RHIT or CPC or CCS required.