APC Coordinator Virtual

Note : This employer is open to candidates who want to work remote. All the benefits and perks you need for you and your family :

Paid Days Off from Day One

Student Loan Repayment Program

Career Development

Whole Person Wellbeing Resources

Mental Health Resources and Support

Our promise to you :

Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Schedule : Full Time

Shift : Days

Location : 3100 East Fletcher Avenue Tampa, Florida 33613

The community you'll be caring for : AdventHealth Division

AdventHealth Tampa, a faith-based not-for-profit 626-bed tertiary-level acute care hospital located in the uptown district of Tampa, Florida, specializes in advanced cardiovascular medicine, neuroscience and neurology, digestive health, orthopedics, women's services, pediatrics, oncology, endocrinology, bariatrics, wound healing, sleep medicine and general surgery including minimally invasive and robot-assisted procedures. GME programs on the hospital campus currently include general surgery, obstetrics and gynecology, internal medicine and transitional year.

AdventHealth Tampa is home to the renowned AdventHealth Pepin Heart Institute, a recognized leader in cardiovascular disease prevention, diagnosis, treatment and leading-edge research - caring for Tampa Bay's hearts for over 35 years.

The Kiran C. Patel Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine, advanced surgery and more - contributing valuable knowledge that leads to tomorrow's cures for conditions such as heart failure, cancer and other diseases."

The ro le you'll contribute :

The Ambulatory Payment Classification (APC) Coordinator is responsible for assigning, monitoring, and evaluating the assignment of CPT and HCPCS Level II procedure codes for grouping into Ambulatory Payment Classifications (APCs) and statistical reporting. Responsible for monitoring the outpatient APC reimbursement for all facilities in the West Florida Division. Monitoring and resolving APC edits to ensure all facilities are receiving accurate reimbursement under OPPS. The APC Coordinator may assist with monthly quality reviews, RAC and post-payment audits. Will routinely monitor the Federal Register and other sources of regulatory information to ensure the team is up to date on the latest Coding and payment updates. The APC Coordinator may assist in training outpatient coders on the appropriate resolution of NCCI edits. Work alongside members of the ancillary departments and revenue cycle team to obtain timely resolution of accounts discharged but not final billed as well as ensure we are billing clean claims. The APC Coordinator will assist in the oversight of the outpatient coding queues, training and education.

The val ue you'll bring to the team :

Review and analyze claim denials to perform the appropriate resolution, rebilling, and / or appeals steps.

Assists with developing and implementing strategies and procedures to reduce denials, maximize reimbursements, and promote faster payment.

Resolves claim edits within the EPIC management billing system to ensure successful claim submission.

Monitor payer rejects and denials to determine systemic or data entry issues and report irregularities to management.

Maintains knowledge of third-party payor reimbursement guidelines and managed care contracts.

Responsible for receiving and addressing accounts within 72 hours of being routed to the claims edit work queue and coding review needed work queue.

Qualifications

T he expertise and experiences you'll need to succeed :

• High school grad or equiv degree. Required
• 3+ years of work experience
• RHIA - Registered Health Information Administrator Required or
• RHIT - Registered Health Information Technician Required or
• Certified Pension Consultant (CPC) Required or
• CCS-Certified Coding Specialist Required

Interested in working from home? This employer is open to candidates who want to work remote.

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