LifePoint Health Business Services, located in Johnstown, PA, is a centralized revenue cycle service center supporting multiple hospitals in the LifePoint Health network. Services provided by LifePoint Health Business Services range from hospital billing to claims follow up and customer service.
Position is immediate work from home opportunity.
Responsible for providing coding review and support related to inpatient and/or outpatient coding bill edits, payer specific DRG audits, RAC audits and account resolution.
Works with departments to provide coding rationale with billing edits/rejects and audit findings.
Maintains knowledge and provides to BSC and ancillary departments updates/changes regarding coding that include but are not limited to CPT, ICD-10, APC.
Develops and directs coding education and assistance with all departments, consulting with managers and staff on developmental needs for new processes and making change recommendations as needed
Performs inpatient coding audits using ICD-9-CM, ICD-10-CM/PCS, DRG validation (3Mcoding software) utilizing appropriate coding references via scanned, electronic and hybrid medical records.
Utilizes hospital abstracting system for coding validation when applicable.
Prepares preliminary results for review by the requesting party.
Reviews DRG change disagreements with the Director.
Assists in preparation of the final quarterly audit reports.
Maintains productivity levels while maintaining a 97% accuracy rate by third party auditors.
Assists with special projects as necessary