Overview

Our team members are the heart of what makes us better.

At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Coding Compliance Specialist performs reviews by validating accuracy of the coding billed in relation to the medical documentation across Hackensack Meridian Health (HMH) network. Determines if a discrepancy exists in the coding and documents the findings using standard documentation guidelines applicable to the Outpatient Coding audit program.

Thee Ideal Candidate will be well versed in Correct Coding Initiative and Medical Necessity Policies and Outpatient Claim Editor.

Responsibilities

A day in the life of a Coding Compliance Specialist at Hackensack Meridian Health includes:

• Must code a wide variety of complex outpatient services such as interventional radiology, ambulatory surgery, emergency room and observation.
• Reviews medical records to determine if facility coding is accurate.
• Utilizes modifier application following appropriate Medicare and National Correct Coding Initiative (NCCI) guidelines
• Ability to write professional notes based on quoting resources of Official Coding guidelines, International Classification of Diseases (ICD)-10 Coding Handbook, Coding Clinic and/or other recognized sources.
• Review appeal information and render coding decisions to either uphold or overturn original findings.
• Must have thorough understanding of ICD-10 Coding; Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) coding systems; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC)
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• High School diploma, general equivalency diploma (GED), and/or GED equivalent programs.
• Minimum of 2+ years of experience in Hospital Trauma 1 and/or Academic Teaching facility.
• Excellent verbal and written communication skills.
• Experience with and expertise with Medicare Local Coverage Determinations (LCD) and National Coverage Determinations (NCD).
• Excellent written and verbal communication skills.
• Proficient computer skills including but not limited to Microsoft Office and Google Suite platforms.

Education, Knowledge, Skills and Abilities Preferred:

• Associate's Degree or higher in Health Information Management (HIM) or healthcare related field.

Licenses and Certifications Required:

• An approved American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) coding credential.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today!

Our Network

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.