[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 the purpose of 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 E-Verify for more information about E-Verify.