HBS Manager Medical Review and Coding AdventHealth Corporate
Location Address: 18501 Murdock Circle Suite 501 Port Charlotte, FL 33948
Top Reasons To Work At AdventHealth Corporate
Immediate Health Insurance Coverage
Career growth and advancement potential
Full-Time, Monday â“ Friday
You Will Be Responsible For:
Coordinates assignments with internal and contracted staff to ensure adherence to established timelines for completion of work items
Monitors workflows to ensure timely completion of work and assists in troubleshooting barriers that impede progress
Provides regular feedback to contracted agencies related to performance and expectations.
Performs monthly audits related to coding and medical review activities to ensure compliance with regulatory guidelines. Continually evaluates team services and identifies, recommends and executes on enhancements or modifications that increase the quality of services and/or mitigates risk.
Utilizes meaningful data tracking and analysis to identify areas for improvement and continually pushes the organization toward higher levels of accountability and quality.
Provides ongoing education for department staff related to ICD-10 coding, and industry and regulatory changes as well as trends noted during audits.
Compiles data for monthly incentives and assists in establishing productivity standards for department.
Serves as an expert resource related to billing, bill hold, coding, medical review processes.
Assists in compiling data to show trends related to OASIS review, including those that could impact the agencyâ™s outcomes and/or process measures.
Participates in regular agency calls to ensure coordination of services related to bill hold, medical review, coding issues/concerns/ successes.
Performs medical review and coding duties as needed to ensure smooth functioning of department.
Participates in and presents education sessions, mentoring or agency education sessions as required to enhance knowledge base of clinicians.
Maintain quality of coding review with score of 95% or greater on ongoing quality audits.
Adheres to federal/state guidelines, rules and regulations, statutes, and law.
Utilizes time management skills to achieve daily productivity standards and documentation submission requirements.
Attract, develop, coach, and retain high-performance team members.
Mentor and/or train other team members related to medical review and coding functions
Maintains strong customer service and business orientation; understands the meaning and implications of key financial indicators; assesses the financial implications of decisions; evaluates options and how decisions and tactics will impact agency customers.
Flexibility as may be asked to work on additional projects
What You Will Need:
At least 5 years home care experience in a Certified home care agency in a management, operations, or QAPI role
Relevant background in homecare, coding and reviewing Plan of Care orders.
Experience in diagnosis coding of home care records including OASIS review
One of the following coding certifications:
Home Care Coding Specialist: Diagnosis (HCS-D)
Board Certified Home Health-Coding (BCHH-C)
AND one of the following OASIS certifications:
Certificate for OASIS Specialist â“ Clinical (COS-C)
Home Care Clinical Specialist â“ OASIS (HCS-O)
Other National coding or OASIS certifications may be considered
AdventHealth Central Billing Office (CBO) provides coding and medical review services for system-wide home care and hospice agencies. The Home-Based Services (HBS) Manager Medical Review/Coding is responsible for oversight of the medical review and coding services being provided by the CBO staff and contracted agencies.
Supports and participates as needed in reviewing and analyzing documentation present in the medical record to assign diagnoses codes as described by the physician(s) of record. Evaluates patient data, and consistency of OASIS documentation and assessments to ensure appropriateness, completeness, and compliance with federal and state regulations. Ensure appropriate ICD-10CM coding and sequencing and works with clinical staff to clarify and correct documentation and data integrity issues as they related to coding, OASIS, plan of care and other regulatory requirements.
The employee must be able to function with a high degree of independence and considerable discretion as work may be completed onsite or remotely
This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.