Virtual APC HIM Coding Coordinator

AdventHealth • Maitland, FL

428d

About The Position

The Ambulatory Payment Classification (APC) Coordinator plays a crucial role in ensuring accurate outpatient coding and reimbursement for AdventHealth Central Florida South Division facilities. This position involves monitoring and evaluating the assignment of CPT and HCPCS Level II procedure codes, resolving APC edits, and assisting with quality reviews and audits. The coordinator will work closely with various departments to ensure timely billing and compliance with regulatory requirements, contributing to the overall efficiency and effectiveness of the revenue cycle.

Requirements

• RHIA, RHIT, CPC, or CCS certification required.
• Minimum of three (3) years of proven outpatient coding experience.
• Excellent communication skills.
• Progressive professional growth in the field of outpatient coding.
• Exhaustive knowledge of outpatient coding and working knowledge of ICD-10-CM, CPT, NCCI edits, and regulatory compliance requirements.

Responsibilities

• Assign, monitor, and evaluate CPT and HCPCS Level II procedure codes for grouping into Ambulatory Payment Classifications (APCs).
• Monitor outpatient APC reimbursement for all AdventHealth Central Florida South Division facilities.
• Resolve APC edits to ensure accurate reimbursement under OPPS.
• Assist with monthly quality reviews, RAC, and post-payment audits.
• Monitor the Federal Register and other regulatory sources for updates on coding and payment.
• Train outpatient coders on resolving NCCI edits.
• Oversee outpatient coding queues, training, and education.
• Review and analyze claim denials and perform appropriate resolution steps.
• Develop and implement strategies to reduce denials and maximize reimbursements.
• Resolve claim edits within the EPIC management billing system.
• Build relationships with ancillary departments and revenue integrity for timely resolution of accounts.
• Maintain knowledge of third-party payor reimbursement guidelines and managed care contracts.
• Code and abstract charts in accordance with ICD-10-CM conventions and Medicare specifications.

Benefits

• Benefits from Day One
• Paid Days Off from Day One
• Career Development

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: No Education Listed