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Medical Review and Coding Specialist - HBS job in Altamonte Springs at AdventHealth Corporate

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Medical Review and Coding Specialist - HBS at AdventHealth Corporate

Medical Review and Coding Specialist - HBS

AdventHealth Corporate Altamonte Springs, FL Full Time
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HBS Medical Review and Coding Specialist AdventHealth Corporate

Location Address: 900 Hope Way Altamonte Springs, FL 32714

Top Reasons To Work At AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential

Work Hours/Shift:

  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Completes accurate coding for assigned agencies utilizing the agency’s EMR and any “scrubbing” software to assess clinical records and apply appropriate ICD-10-CM codes.
  • Reviews clinician documented OASIS and draft Plan of Care/485 and returns recommendations of edits to the clinician completing assessment and clinical supervisor/PI of agency. Resources CMS regulations, industry standards and coding convention as supported by clinical documentation.
  • Provides clear written recommendations related to changes to plan of care following review of clinical documentation, referral information and documents from hospital/physician office.
  • Identifies trends related to OASIS review, including those that could impact the agency’s outcomes and/or process measures and shares with manager.
  • Maintain quality of coding review with score of 95% or greater on ongoing quality audits.
  • Attends/participates in ongoing learning and education in ICD-10 coding, and industry and regulatory changes
  • Adheres to federal/state guidelines, rules and regulations, statutes and law.
  • Utilizes time management skills to achieve daily productivity standards and documentation submission requirements.
  • Ability to mentor and/or train other team members related to medical review and coding functions
  • Flexibility as may be asked to work on additional projects

What You Will Need:

  • At least 2 years home care experience in a Certified home care agency
  • Experience in diagnosis coding of home care records including OASIS review
  • Current RN, PT, OT, or ST license in the state of residence, preferred
  • Background in management, operations, or quality assurance in a home care agency, preferred
  • Hospice experience, preferred
  • One of the following coding certifications:
    • Home Care Coding Specialist:  Diagnosis (HCS-D)
    • Board Certified Home Health-Coding (BCHH-C)

AND one of the following OASIS certifications:

  • Certificate for OASIS Specialist – Clinical (COS-C)
  • Home Care Clinical Specialist – OASIS (HCS-O)

Other National coding or OASIS certifications may be considered

Job Summary:

AdventHealth Central Billing Office (CBO) provides coding and medical review services for system-wide home care and hospice agencies.  The Home-Based Services (HBS) Medical Review and Coding Specialist is responsible for reviewing and analyzing documentation present in the medical record to assign diagnoses codes as described by the physician(s) of record.  Evaluates patient data, and consistency of OASIS documentation and assessments to ensure appropriateness, completeness, and compliance with federal and state regulations. Ensure appropriate ICD-10CM coding and sequencing and works with clinical staff to clarify and correct documentation and data integrity issues as they relate to coding, OASIS, plan of care and other regulatory requirements

Applies current coding guidelines, implements regulatory changes, obtains additional and/or clarification of documentation from physicians and clinical staff via clerical admin department to assure documentation supports diagnoses coded.

The employee must be able to function with a high degree of independence and considerable discretion as work may be completed onsite or remotely.

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

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