Coding Account Resolution Specialist

  • HHS Culinary and Nutrition Solutions, LLC (USA)
  • Nashville, TN
  • 7mo ago
  • Full-Time
  • Remote

Location:

HealthTrust Workforce Solutions External - CCST

Pay Rate:

Hourly - Hourly Plan, 43.00 USD Hourly

Job Description

Responsibilities

Company Overview

HHS is a private, family-owned business dedicated to caring for its team members and providing honest, quality-driven customer service. Founded in 1975, HHS now supports nearly 1,000 customers across various sectors including healthcare and hospitality.

Position Overview

The Coding Account Resolution Specialist II (CARS-II) is responsible for resolving outpatient coding-related alerts and edits for Same Day Surgery (SDC), Observation (OBV), Wound Care, and Outpatient Cardiology accounts, primarily post initial/final coding. This role ensures accurate account resolution, compliance with coding standards, and timely communication to prevent billing delays.

Key Responsibilities

  • Compile and manage daily worklists from eRequest, CRT, and/or other alert/edit systems.
  • Review and resolve alerts/edits for: Same Day Surgery (SDC), Observation (OBV), Wound Care, and Outpatient Cardiac Cath.
  • Provide backup coverage for Emergency Department (ED), Recurring (RCR), Clinical (CLI), and Provider Office Visit (POV) accounts.
  • Document detailed notes in eRequest when alerts/edits cannot be resolved or need rerouting.
  • Escalate issues as necessary to avoid billing delays.
  • Monitor aging accounts, prioritize resolutions, and report trends to leadership.
  • Collaborate with billing, revenue integrity, and Medicare Service Center teams to resolve complex edits.
  • Communicate coding revisions to appropriate stakeholders.
  • Assist Coding Leads/Managers with unbilled reason codes (URCs).
  • Complete MOCK abstracts when required.
  • Maintain compliance with CMS, AHA, and company coding/billing guidelines.
  • Participate in ongoing education to maintain current coding knowledge.
  • Perform additional duties as assigned.

Required Knowledge, Skills & Abilities

  • Strong knowledge of ICD-10-CM, CPT/HCPCS, and reimbursement methodologies.
  • Proficiency with Meditech/Meditech Expanse, 3M/Solventum encoder, HPF/MPF, and Microsoft Office (Excel proficiency required).
  • Ability to manage multiple priorities efficiently and work independently.
  • Strong analytical and problem-solving skills.
  • Excellent communication, organization, and decision-making abilities.
  • Demonstrated ability to collaborate effectively with cross-functional teams.

Qualifications

  • Education: High school diploma or GED required; Associate or Bachelor’s in HIM/HIT preferred.
  • Experience: Minimum of 3 years of facility outpatient coding, including SDC, OBV, IVR, Cardiology, and Wound Care.
  • Certification: RHIA, RHIT, or CCS preferred.

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Billing Identifier:

CC 3271 Hourly