Coding Audit and Education SpecialistApply Now
***Xtend offers competitive benefits including; Medical/Dental/Vision, Generous Paid Time Off/Paid Holidays/Monthly Bonus Eligibility/Tuition Reimbursement/401k plan plus Employer Match/Professional Development***
Xtend Healthcare, a Navient company, is nationally recognized as the industry-leading provider of comprehensive revenue cycle solutions to hospitals and health systems. Sustaining healthcare revenue cycle improvement is our exclusive focus with experience in all 50 states and more than 30 years of dedicated health revenue cycle experience. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.
Xtend Healthcare focuses on both clinical and financial interoperability to maximize collection of net revenue. Xtend Healthcare provides an array of solutions for our customers including full and partial revenue cycle outsourcing, third-party insurance follow-up, self-pay, coding, CDI, and consulting services.
THIS POSITION IS REMOTE - WORK FROM HOME.
The Coding Audit and Education Specialist is responsible for accurately coding and auditing (ICD-10-CM, CPT, HCPCS, Level I & II modifiers) Inpatient Facility, outpatient facility emergency room, outpatient surgery, observation, outpatient facility ancillary, recurring therapy, clinic or professional coding or coding edits and denials resolution. Primary focus will be for external customer projects. Will be working with multiple facility specific, state billing and coding guidelines as well as various Medicare Administrative Contractors nation-wide. Will provide coding education and training based on audit findings as requested to external customers as requested. Will also provide coding education and training to internal (Xtend) coders as requested.
1. Project Work.
- Facility Coding and Auditing (Inpatient, ER, OPS, OBS, Ancillary, Recurring Therapy, Clinic, etc.).
- Professional Coding and Auditing.
- Coding Edits and Denials Resolution.
2. Educations and Training.
- Develop coding education presentations as requested.
- Provide coding education and training to customers as requested.
- Provide coding education and training to internal coders as requested.
3. Record Keeping.
- Completion of Masterlog of accounts audited daily.
- Completion of Time Allocation reports daily.
- Identifies trends while coding and auditing.
- Creation of presentations and reports.
- Identifies potential issues or errors.
5. Customer Service.
- Client liaison to communicate account inquiries.
- High school diploma with some college (additional equivalent experience above the required minimum may substitute for the required level of education)
- Minimum of 10 years of experience with production coding and Inpatient experience. This should include hospital and physician practice. (additional equivalent education above the required minimum may substitute for the required level of experience)
- Training and mentoring experience
- Coding Certifications: The following are recognized professional certifications: Registered Health Information Technologist (RHIT), Certified Inpatient Coder (CIC) or Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or Certified Coding Specialist (CCS-P). Coding Audit and Education Specialist are required to possess at least one of the above professional services coding certifications.
- Continuing Education Requirements: Medical coders shall maintain the required continuing education hours in order to maintain current and proper national certification(s) requirements for this position.
- Complete a pre-employment medical coding assessment that is provided, developed, and administered by candidate management instructions.
- An understanding of healthcare billing practices and compliant claims preparation for both governmental and commercial payers.
- Revenue Cycle Certifications: The following are recognized professional certifications: Certified Professional Account Representative (CPAR), Certified Revenue Cycle Representative (CRCR) or Certified Professional Biller (CPB).
- Electronic health record (EHR) expertise, including knowledge of a variety of vendors.
- Specialty Coding Certifications: The following are recognized professional certifications: Ambulatory Surgical Center (CASCC), Anesthesia and Pain Management (CANPC), Cardiology (CCC), Cardiovascular and Thoracic Surgery (CCVTC), Chiropractic (CCPC), Dermatology (CPCD), Emergency Department (CEDC), Evaluation and Management (CEMC), Family Practice (CFPC), Gastroenterology (CGIC), General Surgery (CGSC), Hematology and Oncology (CHONC), Internal Medicine (CIMC), Interventional Radiology and Cardiovascular (CIRRC), Obstetrics Gynecology (COBGC), Orthopedic Surgery (COSC), Otolaryngology (CENTC), Pediatrics (CPEDC), Plastics and Reconstructive Surgery (CPRC), Rheumatology (CRHC), Surgical Foot & Ankle (CSFAC), and Urology (CUC).
- Ability to create power point presentations in a clear and concise manner.
- Ability to articulate clearly coding educational topics.
- Experience with training and mentoring others.
- Ability to function independently and as a team player in a fast-paced environment required. Responding to emails timely is a requirement.
- Must be able to maintain the company accuracy rating of 95%.
- Must meet set weekly quota for productivity. This is a production coding environment and very fast paced.
- Knowledge of the International Classification of Diseases, Clinical Modification (ICD-CM); Healthcare Common Procedure Coding System (HCPCS); and Current Procedural Terminology (CPT) including E&M.
- Must possess a working knowledge of Medicare and Local Medical Review Policy Guidelines.
- Resolution of coding related edits and denials (NCCI, NCD, LCD, MUE) with appropriate modifier application.
- Knowledge of reimbursement systems, including Prospective Payment System (PPS); Ambulatory Payment Classifications (APCs); and Resource-Based Relative Value Scale (RBRVS).
- Practical knowledge and understanding of industry nomenclature; medical and procedural terminology; anatomy and physiology; pharmacology; and disease processes.
- Practical knowledge of medical specialties; medical diagnostic and therapeutic procedures; ancillary services (includes, but is not limited to, Laboratory, Occupational Therapy, Physical Therapy, and Radiology).
- Make well-informed, effective, and timely decisions, even when data are limited, or solutions produce unpleasant consequences; perceives the impact and implications of decisions.
- Utilize medical computer software programs to abstract, analyze, and/or evaluate clinical documentation and enter/edit diagnosis, procedure codes and modifiers.
- Clearly express information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information. Speaking and writing (specifically email) in an organized manner is required.
- Display courtesy, empathy, and tact, developing and maintaining effective relationships with others; effectively work with individuals who are difficult, hostile, or distressed to resolve differences; and be able to relate well to people from varied backgrounds and in different situations.
- Work with internal and external customers to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations.
All offers of employment are contingent on standard background checks. Navient and certain of its affiliated companies are federal, state and/or local government contractors. Should this position support a Federal Government contract, now or in the future, the successful candidate will be subject to a background check conducted by the U.S. Government to determine eligibility and suitability for federal contract employment for public trust or sensitive positions. Positions that support state and/or local contracts also may require additional background checks to determine eligibility and suitability.
EOE Race/Ethnicity/Sex/Disability/Protected Vet/Sexual Orientation/Gender Identity. Navient Corporation and its subsidiaries are not sponsored by or agencies of the United States of America.
Navient is a drug free workplace.
Comprehensive Health, Dental and Vision Plans
401K with Company Match (after 6 months)
Generous PTO Starting at 15 Days and 8 Paid Holidays
Paid Parental Leave and Adoption Assistance
Employee Stock Purchase Plan