Coding Validation Spec 2

Inova Health is looking for a dedicated Coding Validation Specialist 2 to join the PB Coding Operations team. Full-time Day Shift: Monday–Friday, general office hours, working remotely.

This position is eligible for remote work for candidates residing in the following states – VA, MD, DC, DE, FL, GA, NC, OH, PA, SC, TN, TX, WV.

Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. 

Featured Benefits:

• Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.

• Retirement: Inova matches the first 5% of eligible contributions – starting on your first day.

• Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.

• Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.

• Work/Life Balance: offering paid time off, paid parental leave, flexible work schedules, and remote and hybrid career opportunities.

Coding Validation Specialist 2 Job Responsibilities:

• Codes and reviews assigned records within the defined quality standards of 95 percent for diagnosis, CPT, modifier and evaluation/management code assignments.
• Ensures that the coding and review of assigned records within the defined productivity standards, based on service-line production standards, equate to eight – 10 charts per hour.
• Actively participates in coding education sessions.
• Reviews and analyzes all pertinent documentation in the medical record to support identification and assignment of appropriate code selection for the level of service provided by the physician or mid-level provider.
• Reviews and revises, as necessary, required data elements initially identified by other staff (e.g. patient type, admitting diagnosis, referring physician for consult codes, or admit type with appropriate place of service).
• Ensures correct CPT code selection for the level of service billed (i.e. POS to IP code mismatch, or invalid code for POS; changes consult code to E/M based on payer-specific criteria).
• Communicates with the responsible physician or mid-level provider accordingly to obtain additional supporting documentation, or clarification required for code assignments and processes, including following an escalation or secondary review as necessary.
• Assigns and revises all codes, modifiers, and edits using 3M coding software.

Minimum Requirements: 

• Education: High School diploma or GED
• Experience: One years of coding experience required.
• Certifications: One of the following credentials required: CPC-A, CPC, COC, CCS, CCS-P, CCA or RHIT.