Located in the metropolitan area of Sacramento, the Adventist Health corporate
headquarters have been based in Roseville, California, for more than 40 years.
In 2019, we unveiled our WELL-certified campus - a rejuvenating place for
associates systemwide to collaborate, innovate and connect.
Whether virtual or on campus, Adventist Health Roseville and shared service
teams have access to enjoy a welcoming space designed to promote well-being and
inspire your best work.
Job Summary:
Reviews SDS and OBV records to identify the diagnosis and procedure codes
performed during the patients stay are valid and in accordance with coding
conventions and guidelines. Records types including same day surguery and
observation encounter types. Works on routine assignments within defined
parameters, established guidelines and precedents. Follows established
procedures and receives daily instructions on work.
Job Requirements:
Education and Work Experience:
High School Education/GED or equivalent: Required
Working knowledge of hospital Cerner EMR (electronic medical record):
Required
Five years' SDS/OBV coding and health care experience: Required
Licenses/Certifications:
AHIMA Certified Coding Specialist (CCS): Required
Essential Functions:
Reviews APC and payor denials and provides feedback to leadership and other
departments. Performs outpatient audits including payor audits and overall
coding accuracy audits. Maintains denial and other spreadsheets for assigned
denial and audit duties. Attends various meetings and provides coding
feedback. Researches and provides feedback and direction to outpatient coding
associates. Ensures coding corrections and edits are updated. Keeps abreast
of regulatory changes related to coding and documentation and communicates
these updates and changes to coding and leadership. Provides edicational
sessions and training resources to coding associates. Understands and assists
leadership and coding with reaching departmental metric goals. Abstracts and
assigns ICD-10-CM diagnosis codes and CPT procedure codes from the SDS and
OBV patient record to ensure accurate APC assignment and to provide
information required for reimbursement and statistical data submissions.
Validates appropriate dates of service against documentation in the EMR for
SDS/OBV encounters. Completes required abstract fields in registration
conversation on SDS/OBV encounter for OSHPD and other data submissions. Uses
knowledge of modifier use to ensure accurate application on various payor
types. Communicates with appropriate departments related to charge
corrections/modifications. Audits medical records to ensure proper coding is
completed and to ensure compliance with federal and state regulatory
agencies. Follows coding guidelines and legal requirements to ensure
compliance with federal and state regulatory bodies. Reviews, understands and
applies quarterly coding clinics, coding guidelines and coding conventions of
ICD-10-CM references. Collaborates to provide coding feedback and education
to departmental leadership regarding completeness and accurateness of
documentation and physician coding practices. Analyzes content of reports and
software edits to facilitate revisions with appropriate departments - NCCI
edits.
Follows up coding holds, revenue cycle department holds including related and
all other email communication.
Collaborates to provide coding feedback and education to departmental
leadership regarding completeness and accuracy of documentation and physician
coding practices. Maintains required online Healthstream education courses.
Attends meetings and training pertaining to coder education, audit reviews,
staff meetings, outpatient coder roundtable meetings, and SDC to OBV charges.
Performs other job-related duties as assigned.
Organizational Requirements:
Adventist Health is committed to the safety and wellbeing of our associates and
patients. Therefore, we require that all associates receive all required
vaccinations as a condition of employment and annually thereafter, where
applicable. Medical and religious exemptions may apply.
Adventist Health participates in E-Verify. Visit
https://adventisthealth.org/careers/everify/ for more information about
E-Verify. By choosing to apply, you acknowledge that you have accessed and read
the E-Verify Participation and Right to Work notices and understand the contents
therein.
Adventist Health is a faith-based, nonprofit, integrated health system serving
more than 100 communities on the West Coast and Hawaii with over 440 sites of
care, including 27 acute care facilities. Founded on Adventist heritage and
values, Adventist Health provides care in hospitals, clinics, home care, and
hospice agencies in both rural and urban communities. Our compassionate and
talented team of more than 38,000 includes employees, physicians, Medical Staff,
and volunteers driven in pursuit of one mission: living God's love by inspiring
health, wholeness and hope.