Certified Coder, Acute Hospital ED, Cancer & Edits

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect.

Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work.
Job Summary:

Reviews acute hospital outpatient emergency department (ED), medical oncology, adult outpatient rehab including cardiac rehab patient records including charge capture/entry to identify the diagnosis and procedure codes performed during the patient’s stay are valid and in accordance with coding conventions and guidelines. Record types include ED including charge capture/entry, medical oncology cancer and adult outpatient rehab including cardiac rehab encounter types. Handles returned for coding/coding edits workflow to resolution. Works on routine assignments within defined parameters, established guidelines and precedents. Follows established procedures and receives daily instructions on work.
Job Requirements:

Education and Work Experience:

- High School Education/GED or equivalent: Required

- Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred

- Three years’ outpatient emergency department (ED), medical oncology, adult outpatient rehab and cardiac rehab coding experience: Preferred

- Experience in an acute care setting: Preferred

Licenses/Certifications:

- AHIMA Certified Coding Specialist (CCS): Required

- AAPC Certified Professional Coder – CPC (critical access facilities): Preferred

- AAPC Certified Outpatient Coder – COC: Preferred

- AHIMA Certified Coding Associate (CCA), AHIMA RHIT/RHIA (Registered Health Information Technologist) or (Registered Health Information Administrator): Required – prior to 1-1-2018 – not accepting new CCA, RHIT/RHIA certifications

- All Associates hired Jan 1, 2018, and prior have been grandfathered in as acceptable certifications. New hires will be required to have a CCS or CPC dependent on site assignment certification only: Required

- Maintain appropriate credential related to essential job assignment: CCS or CPC or COC. For those that were grandfathered in prior to Jan 1, 2018, will be expected to maintain CCA, RHIT, or RHIA certification: Required

- Certified Coding Specialist (CCS) or Certified Coding Associate (CCA): Required

Essential Functions:

- Abstracts and assigns diagnosis codes and procedure codes from the ED patient record to provide information required for billing and reimbursement. Abstracts and assigns diagnosis codes and procedure codes from the MedOnc recurring patient record to provide information required for billing and reimbursement. Abstracts and assigns diagnosis codes and procedure codes from the adult outpatient rehab and cardiac rehab patient record to provide information required for billing and reimbursement. Validates appropriate dates of service against documentation in the EMR for MedOnc recurring encounters with multiple service dates. Completes required abstract fields in registration conversation on ED encounter for OSHPD (state reporting) data submissions.

- Posts, corrects and validates ED charges using the ED FCT, ED Ad Hoc FCT. Validates and corrects infusion and injection charges in ED and MedOnc. Appropriates utilization of modifiers.

- Audits medical records to ensure proper coding is completed and to ensure compliance with federal and state regulatory agencies. Follows outpatient coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.

- Follows up coding holds, revenue cycle department holds including related and all other email communication. Collaborates to provide coding feedback and education to departmental leadership regarding complete and accurat