Baltimore, Maryland
Summit, New Jersey
Easton, Maryland
Durham, North Carolina
Posted: 01-Apr-25
Location: Altamonte Springs, Florida
Categories:
Internal Number: 25010705
All the benefits and perks you need for you and your family:
- Benefits from Day One
- Paid Days Off from Day One
- Career Development
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
Location: Remote
The community you’ll be caring for: AdventHealth Orlando
- Located on a lush tropical campus, our flagship hospital, 1,368-bed AdventHealth Orlando
- Serves as the major tertiary facility for much of the Southeast, the Caribbean and South America
- AdventHealth Orlando houses one of the largest Emergency Departments and largest cardiac catheterization labs in the country
- We are already one of the busiest hospitals in the nation, providing service excellence to more than 32,000 inpatients and 125,000 outpatients each year
The role you’ll contribute:
Under the general supervision of the Coding Quality Manager, the Data Quality Reviewer is responsible for validating the coding performed by inpatient or outpatient coders. Random and/or target samples are reviewed, and the results are provided to management and feedback to the individual coder. Assist with educating all coders and Medical Staff members while demonstrating a willingness to educate throughout the organization as needed. Maintains extensive knowledge of all coding standards and effectively communicates with appropriate individuals. Actively participates in outstanding customer service and accepts responsibility for maintaining relationships that are equally respectful to all.
The value you’ll bring to the team:
- Prepares statistical reports conveying the individual and overall accuracy of coding.
- Reviews, analyzes, and interprets clinical documentation, seeking clarification from the physician when discrepancies exist. Effectively communicates with physicians and allied health personnel the need for comprehensive, accurate, timely clinical documentation.
- Assists with writing compelling appeals to all DRG denials from outside agencies referencing Official Coding Guidelines and Coding Clinic advice as appropriate to defend the DRG assignment and protect the organization’s reimbursement.
- Serves as a resource to other departments in the Revenue Cycle to ensure business continuity and optimal revenue cycle management.
- Uses critical thinking and sound judgment in decision-making, balancing reimbursement considerations with regulatory compliance.
- Assumes personal responsibility for professional growth, development, and continuing education to maintain a high level of proficiency.
The expertise and experiences you’ll need to succeed:
REQUIRED:
- High School Grad or Equiv and two years of coding education (medical coding certificate program, diploma or 2-year HIM program), including medical terminology, anatomy and physiology, and pathophysiology coursework. Required
- 5 of inpatient hospital coding and/or auditing experience, including cases requiring specialized coding skills, such as cardiovascular surgery, neurosurgery, trauma surgery, neonatology, pediatrics, plastic and reconstruction surgery, bariatric surgery, cardiology, and other services and procedures provided in a tertiary care facility. Required
- RHIA - Registered Health Information Administrator Required or
- RHIT - Registered Health Information Technician Required or
- CCS-Certified Coding Specialist Required or
- Certified Pension Consultant (CPC) Required or
- CIC - Certified in Infection Control Required
