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Posted by: Sentara on Nov 14, 2017


Location:

Virginia Beach, VA

Job Description:

Job Description: Job Description
Sentara Healthcare is recruiting for an experienced Full-time Coding Auditor- RAC. We are offering up to a $3,000.00 Sign-on bonus for qualified candidate. Ability to work part-time from home after successful training that is done at our HIS Landstown location in Virginia Beach, VA. This position is responsible for determining that the ICD 9, ICD 10 and CPT coding is supported by the clinical documentation in the medical record. Also review and validate medical necessity information from CMS Local Coverage Determination (LCD) with medical record documentation. Must be a proficient coder with thorough knowledge of coding guidelines and coding clinics. Primary function is the ability to write a complete comprehensive appeal to support claims coded appropriately. Also performs a number of functions including those of internal auditing, coder education, physician documentation education, liaison with external coding auditors and insurance companies. careerconnection

The Recovery Audit Contractor (RAC) Auditor is responsible for determining that the ICD 9, ICD 10 and CPT coding is supported by the clinical documentation in the medical record. Must be a proficient coder with thorough knowledge of coding guidelines and coding clinics. Primary function is the ability to write a complete comprehensive appeal to support claims coded appropriately. Also performs a number of functions including those of internal auditing, coder education, physician documentation education, liaison with external auditors for corporate audits.

Education Level
Associate's Level Degree - HEALTH INFORMATION MANAGEMENT OR
Bachelor's Level Degree - HEALTH INFORMATION MANAGEMENT
Experience
Required: Coding - 5 years
Preferred: None, unless noted in the "Other" section below
License
Required: Cert Coding Specialist, Cert Professional Coder
Preferred: None, unless noted in the "Other" section below
Skills
Required: Communication, Coordination, Critical Thinking, Microsoft Office, Monitoring, Reading Comprehension, Service Orientation, Technology/Computer, Writing
Preferred: None, unless noted in the "Other" section below
Other
Associates in HIM or 2 years in lieu of degree or Bachelor's In HIM degree or 4 years experience in lieu of degree required. Ability to understand and interpret medical records, hospital bills and ChargeMaster. Must demonstrate an understanding of Medicare and other payer guidelines related to billing and charging of observation services, other separately chargeable services, and other lines of service. Must demonstrate knowledge of managed care contracting arrangements as well as notification and clinical review requirements. Must also be knowledgeable of regulatory and compliance requirements for government payers regarding clinical reviews and medical necessity. Previous Healthcare Auditing experience preferred.

Brand: Sentara Healthcare
Educational verification may be required for this position.
In support of our mission "to improve health every day", this is a tobacco-free environment.

HR. Website URL:

http://www.sentaracareers.com/career-opportunities/

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About Sentara Healthcare

Sentara Healthcare is one of the most progressive and integrated health care organizations in the nation, located mainly in Southeast Virginia and Northern North Carolina with additional sites in Charlottesville, Covington, Harrisonburg and Woodbridge, VA. Sentara operates more than 100 care giving sites, including 12 acute care hospitals including 7 in Hampton Roads, 1 in Northern Virginia and 2 in the Blue Ridge Region, 1 in Southwestern Virginia and 1 in Northeastern North Carolina, outpatient care facilities, nursing centers, assisted living centers, advanced imaging centers and about 380 primary care and multi-specialty physicians. Sentara also offers a full range of award-winning health coverage plans, home health and hospice services, physical therapy and rehabilitation services, including Nightingale - the region’s first air ambulance service. Sentara Healthcare is an acknowledged leader in patient safety and quality innovation. Founded in 1888 as the Retreat for the Sick in Norfolk, Virginia, Sentara has ranked for more than a decade among the nation's top integrated healthcare systems by Modern Healthcare magazine and is the #1 most integrated health care system for two consecutive years. We invite you to share our Vision. To be the healthcare of choice in the communities we serve.

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