Organization Overview, Mission, Vision and Values
Washington Regional Medical System (the “System”) is our region’s only locally governed, community-owned, not-for-profit healthcare system. The System includes a 425-bed acute care hospital known as Washington Regional Medical Center (the “Hospital”) which is located in Fayetteville, Arkansas. The Hospital is supported by the System- including primary, specialty and urgent care operations - that span across Northwest Arkansas into Harrison and Eureka Springs. Being heavily supported and invested in our community makes Washington Regional a unique employer, encouraging staff to give back to the community in which we live and work … and give back to each other.
Washington Regional Mission, Vision and Values prove to be a firm foundation and inspiration from which we fulfill our purpose.
Mission : Washington Regional is committed to improving the health of people in communities we serve through compassionate, high quality care, prevention and wellness education.
Vision : To be the leading healthcare system in Northwest Arkansas --- the best place to receive care and the best place to give care.
Values : To treat others – patients and their families, visitors, physicians, and each other – as we would want to be treated.
Position Summary
The role of the Appeals Coordinator reports to the Revenue Integrity Manager. This position is responsible for the management and resolution of claim denials. partnering with the coding department, business office and charge departments to resolve edits on failed claims and claim scrub reports. This position must ensure accurate CPT, UB codes and modifiers are appropriately reported on claims and is responsible for auditing charts for services provided to both inpatients and outpatients. The incumbent will perform focus bill audits when needed and will work with system staff on issues related to documentation in the medical records.
Essential Position Responsibilities
Resolve edits, claim scrub issues and hold bills
Ensure CPT, UB codes and modifiers are accurately reported on claims
Provide education to correct inappropriate use of CPT codes and modifier
Partner with staff to correct issues related to documentation in medical records
Perform focus bill audits as needed
Prepare compliance related audits and provide information for reports, as requested
Cross train to assist with other departmental duties, as requested
Qualifications
Education: Bachelors in Health Information Services, preferred.
Licensure and Certifications: RHIA, RHIT, CCA, CCS, CPC, COC, OR CPMA , required
Experience: Minimum c oding experience of 2-3 years or 3-5 years auditing clinical records, medical necessity, coverage policies and CMS and commercial insurance rules and regulations, required.
Work Environment : This position will spend 80% of work time sitting while performing work in a standard office environment and 20% of work time standing and/or walking short distances while occasionally pushing, pulling, lifting and/or carrying up to 50 lbs.
Community-owned, not-for-profit hospital system serving NWA with comprehensive medical services.