[Hiring] Senior Cancer Center Specialty Certified Coder @Adventist Health

Role Description

Codes for cancer center encounters and maintains required quality and productivity standards while remaining compliant with third party, state and federal regulations.

• Reviews and resolves medical necessity edits that may apply for any outpatient surgical encounters.
• Applies hospital and professional modifiers to CPT codes and processes any errors associated with the revenue cycle process.
• Assists in the design and implementation of workflow changes to reduce coding and billing errors.
• Uses knowledge of data collection systems for medical records.
• Reviews medical record documentation and accurately assigns appropriate ICD-10-CM diagnoses, CPT codes and modifiers as applicable for both the hospital and professional claim.
• Validates and processes any medical necessity edits (local or national coverage determinations) that may apply for hospital and professional coding.
• Monitors Discharged Not Billed (DNB) accounts, ensuring timely, compliant processing of outpatient and inpatient encounters through the hospital and professional revenue cycle.
• Codes and posts charges for outpatient complex cancer center procedures and diagnoses for reimbursement, research, statistical data gathering, and compliance.
• Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes.
• Maintains current knowledge of coding guidelines and reimbursement reporting requirements.
• Demonstrates a high degree of independence in performance of responsibilities, working effectively without direct supervision.

Qualifications

• High School Education/GED or equivalent: Required
• Experience with RadOnc and MedOnc coding: Required
• Experience in an acute care setting: Preferred
• Experience with Varian, Aria, Mosaiq and Cerner Oncology programs: Preferred
• Radiation Oncology Certified Coder (ROCC) certification: Required

Requirements

• Develops physician and departmental relationships.
• Creates physician and coder education for cancer center specialty.
• Performs cancer center coding.
• Handles return for coding review and resolution.
• Performs charge reviews and makes corrections as needed.
• Communicates complex concepts in simple form to non-finance users to understand the appropriate use and limits of information provided.
• 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 here 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.