Navigant Consulting Inc Coding Specialist Outpatient - Heatlh Systems Solutions - Remote Location in BOSTON, Massachusetts

Health System Solutions (HSS) is a newly formed Joint Venture between Navigant Consulting, Inc. and Baptist Health South Florida (BHSF). Health System Solutions will provide revenue cycle management services initially to BHSF and then expand to other providers. This new company combines Baptist Health South Florida’s highly skilled staff and Navigant’s industry-leading RCM expertise, innovative processes and technology tools.

The combination of Navigant’s strong market position in outsourced revenue cycle management and Baptist Health South Florida, as an internationally renowned center of excellence for healthcare services, creates an exceptionally strong company to compete in the ever-changing healthcare services industry. Health Systems Solutions will help healthcare services providers defend, protect, and create value in the midst of transformational change or when facing significant regulatory or legal pressures.

  • Code Emergency and Outpatient Diagnostic records for the classification of all diseases, injuries, procedures, and operations using the ICD10CM and CPT4 coding system

  • Ensure compliance of coding rules and regulations according to Regulatory Agencies (CMS, OIG)

  • Work in a team to meet departmental goals and AR goals

  • Abstract prescribed data elements from the medical records

  • Assign principal diagnosis, secondary diagnoses, and procedures according to principles of ICD10CM and CPT4 coding system after thorough study of the medical record for consistency and optimal reimbursement with at least 95% coding accuracy rate according to national standards and reaching towards desired goals of 98%

  • Code records according to productivity performance standards and goals set by department of 9 Emergency Department/14 Outpatient records an hour

  • Resolves coding system edits before finalizing coded account for appropriate coding and reimbursement

  • Research Coding Clinic, CPT Assistant and HCPCS Coding clinics as references for accurate reporting of procedures

  • Maintain CEUs as set forth by AHIMA’s Certification Commission

  • Complete assigned AHIMA CATS modules

  • Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines

  • High School diploma

  • Coding Certificate

  • 1 year of experience

  • Completion of an AHIMA accredited certified coding specialist program

  • Preferred Certified Coding Specialist (CCS)

  • Completion of a medical terminology and anatomy and physiology college course within past five years

  • Knowledge of encoder system, outpatient prospective payment system; APCs

  • Knowledge of National Local Coverage Determinations (NCD and LCD) Policies

  • Competency in Word and Excel

  • Ability to communicate effectively with coworkers, management staff and physicians

  • CCS certification required within 2 years of employment, if not CCS certified

  • Communicate frequently with co-workers as well as with managers to discern their needs, and be able to express themselves

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Constantly operates a computer and other office equipment to coordinate work

  • Usually remains stationary for the majority of the day

  • Frequently communicates with clients and coworkers and must be able to share information effectively

  • Generally works in an office environment

Health System Solutions is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

Health System Solutions will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.