Coding Validation Specialist 3

Coding Validation Specialist 3

Inova Health is looking for a dedicated Coding Validation Specialist 3 to join the team. Full-time Day Shift: MondayFriday, general office hours, working remotely.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
• Retirement: Inova matches the first 5% of eligible contributions starting on your first day.
• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
• Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Coding Validation Specialist 3 Job Responsibilities:

• Codes and reviews assigned records with defined productivity standards of four charts per hour for complex/intermediate surgeries and five charts per hour for simple surgeries.
• Actively participates in internal pre-bill coding audits, independent coding audits, and coding education sessions.
• Enhances professional growth and development by participating in other relevant continuing education activities.
• Maintains or surpasses Inova Health System-defined quality standards for accurate assignment and validation of the Evaluation and Management (E/M) assignment of 95 percent.
• Ensures correct CPT code for the level of service billed (i.e. Place of Service, Observation codes for Observation Status; Inpatient Codes for Inpatient Status).
• Changes consult codes based on Payer requirements to the appropriate E/M code and appropriate units and/or modifiers maintaining an accuracy of 95 percent or greater.
• Verifies the accuracy, completeness, and quality of ICD-10-CM, CPT-4, and HCPC coding including modifiers, units, and other variables impacting workload accountability and billing.
• Communicates with the responsible physician or mid-level provider accordingly to obtain additional supporting documentation, or clarification required for code assignments and processes, including following an escalation or secondary review as necessary.

Minimum Requirements:

• Education: High School diploma or GED
• Experience: Three years of coding experience required.
• Certifications: One of the following: RHIT, CCS or CPC, COC or CCS-P.

Preferred Qualifications:

• Strong general surgery coding experience