Sr. Cancer Center Specialty Certified Coder (PD, Remote)

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:

Codes for cancer center encounters and maintains required quality and productivity standards while remaining compliant with third party, state and federal regulations. Reviews and resolves medical necessity edits that may apply for any outpatient surgical encounters, applying hospital and professional modifiers to CPT codes and processes any errors associated with the revenue cycle process. Assists in the design and implementation of workflow changes to reduce coding and billing errors. Uses knowledge of data collection systems for medical records. Reviews medical record documentation and accurately assigns appropriate ICD-10-CM diagnoses, CPT codes and modifiers as applicable for both the hospital and professional claim. Validates and processes any medical necessity edits (local or national coverage determinations) that may apply for hospital and professional coding. Monitors Discharged Not Billed (DNB) accounts, and as a team, ensure timely, compliant processing of outpatient and inpatient encounters through the hospital and professional revenue cycle. Codes and posts charges for outpatient complex cancer center procedures and diagnoses for the purpose of reimbursement, research, statistical data gathering, and compliance. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Maintains current knowledge of coding guidelines and reimbursement reporting requirements. Demonstrates a high degree of independence in performance of responsibilities, working effectively without direct supervision.

Job Requirements: