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Coding Account Resolution Specialist
Coding Account Resolution SpecialistHHS, LLC • Nashville, TN, US
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Coding Account Resolution Specialist

Coding Account Resolution Specialist

HHS, LLC • Nashville, TN, US
23 days ago
Job type
  • Full-time
Job description

Company Overview

HHS is a private, family-owned business dedicated to caring for its team members and providing honest, quality-driven customer service. Founded in 1975, HHS now supports nearly 1,000 customers across various sectors including healthcare and hospitality.

Position Overview

The Coding Account Resolution Specialist II (CARS-II) is responsible for resolving outpatient coding-related alerts and edits for Same Day Surgery (SDC), Observation (OBV), Wound Care, and Outpatient Cardiology accounts, primarily post initial / final coding. This role ensures accurate account resolution, compliance with coding standards, and timely communication to prevent billing delays.

Key Responsibilities

  • Compile and manage daily worklists from eRequest, CRT, and / or other alert / edit systems.
  • Review and resolve alerts / edits for : Same Day Surgery (SDC), Observation (OBV), Wound Care, and Outpatient Cardiac Cath.
  • Provide backup coverage for Emergency Department (ED), Recurring (RCR), Clinical (CLI), and Provider Office Visit (POV) accounts.
  • Document detailed notes in eRequest when alerts / edits cannot be resolved or need rerouting.
  • Escalate issues as necessary to avoid billing delays.
  • Monitor aging accounts, prioritize resolutions, and report trends to leadership.
  • Collaborate with billing, revenue integrity, and Medicare Service Center teams to resolve complex edits.
  • Communicate coding revisions to appropriate stakeholders.
  • Assist Coding Leads / Managers with unbilled reason codes (URCs).
  • Complete MOCK abstracts when required.
  • Maintain compliance with CMS, AHA, and company coding / billing guidelines.
  • Participate in ongoing education to maintain current coding knowledge.
  • Perform additional duties as assigned.

Required Knowledge, Skills & Abilities

  • Strong knowledge of ICD-10-CM, CPT / HCPCS, and reimbursement methodologies.
  • Proficiency with Meditech / Meditech Expanse, 3M / Solventum encoder, HPF / MPF, and Microsoft Office (Excel proficiency required).
  • Ability to manage multiple priorities efficiently and work independently.
  • Strong analytical and problem-solving skills.
  • Excellent communication, organization, and decision-making abilities.
  • Demonstrated ability to collaborate effectively with cross-functional teams.
  • Qualifications

  • Education : High school diploma or GED required; Associate or Bachelor's in HIM / HIT preferred.
  • Experience : Minimum of 3 years of facility outpatient coding, including SDC, OBV, IVR, Cardiology, and Wound Care.
  • Certification : RHIA, RHIT, or CCS preferred.
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