Franciscan Health

Role Description The Coder IV Specialist - Professional Anesthesia and Gyn Oncology - Surgical reviews electronic medical record documentation and applies ICD and CPT codes per Official Coding Guidelines, with a specific focus on professional major surgical services. This position abstracts key data elements necessary for billing and data analysis. - Accurately reviews and codes patient records in the following clinical areas: hospitalist rounds and office visits (with repetitive or non-invasive procedures). - Reviews and analyzes the content of the medical record to determine when documentation should be utilized for appropriate assignment of ICD diagnosis codes, CPT repetitive or non-invasive procedure codes, modifiers, hierarchical condition categories, complications, and comorbidities to meet coding guidelines. - Evaluates appropriateness of diagnosis and procedure codes and modifiers utilized in response to Outpatient Code Editor and National Correct Coding Initiative edits. - Meets defined coding accuracy standards. - Meets defined coding productivity standards. - Remains current with coding and industry changes through participation in educational opportunities. - Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders, and adheres to official coding guidelines. Qualifications - High School Diploma/GED - Required - Associate's or Bachelor's Degree in Health Information Management - Preferred - 4 years Coding - Required - Anesthesia/GYN Oncology Experience - Required - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) - Required - or Certified Coding Specialist - Physician (CCS-P) - American Health Information Management Association (AHIMA) - Required - or Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) - Required - or Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA) within 180 days - Preferred - or Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA) within 180 days - Preferred Requirements - TRAVEL IS REQUIRED: Never or Rarely - JOB RANGE: Coder IV Spcl Professional Specialty Svcs Surgical $20.13-$29.95 - INCENTIVE: Not Applicable Equal Opportunity Employer It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Benefits Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

• Design and deliver enterprise-grade digital solutions • Lead the architectural vision and standards • Serve as the Product Owner for digital initiatives • Drive best practices in data applications and automation • Define and update technical standards • Promote and adopt robust solutions for data security and compliance

• Designing and creating tables within data marts, data lakes and data warehouses • Building systems that collect, manage, and convert raw data into usable information for analytics • Expanding and optimizing data and data pipeline architecture • Mentoring junior data engineers and promoting data education

• Assist in the development and implementation of education projects and programs. • Computerize associated training records in the Learning Management System and maintain all training. • Provide secretarial support: greeting visitors, answering phones, and maintaining/updating records/files and inventory of office supplies. • Schedule meetings and coordinate conference room logistics. • Use organizational systems to complete deposits, and manage and record charges, refunds, and other reports, as needed. • Use the registration database to enroll and charge the public to attend classes.

• Analyze the ICD 10 codes suggested by computer-assisted coding software • Ensure alignment with official coding guidelines and electronic medical record documentation • Collaborate with the Clinical Documentation Specialist • Abstract key data elements necessary for billing and data analysis • Accurately review and code patient records • Meet defined coding accuracy and production standards • Demonstrate thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and Payor specific guidelines • Review and analyze medical records to assign appropriate codes • Notify coding leadership of trends for education and feedback

• Develop and maintain all CDI education, training policies and procedures, and CDI reference materials. • Lead training sessions and assess CDI comprehension of covered materials. • Make recommendations for the development of CDI resources and policy and procedure development. • Develop and maintain a consistent CDI operations orientation program and report the CDS’s progress to CDI leadership throughout the orientation and training process. • Serves as the subject matter expert with regards to medical terminology, anatomy/physiology, reimbursement schemes, public reporting of outcomes, quality of patient care outcome measures, and the interpretation of coded data as it relates to revenue cycle compliance.

• Reviews electronic medical record documentation • Applies ICD and CPT codes per Official Coding Guidelines • Abstracts key data elements necessary for billing and data analysis • Accurately reviews and codes patient records • Reviews and analyzes the content of medical records • Evaluates appropriateness of diagnosis and procedure codes • Meets defined coding accuracy and productivity standards • Remains current with coding and industry changes

Role Description The Employee/Occ Health Representative is responsible for managing client relations and a variety of employee health duties, including: - Various occupational health program activities - Revenue cycle activities - Client account reconciliation - Client management meetings - Maintaining a client issues list - Understanding various client/vendor processes for account follow-up - Proposing relevant programs This position reviews reported client or account issues and works proactively with appropriate clients, Hospital Departments/vendor, FAIS, and ABO/CBO team members for timely resolution of the issue. Hours/Days: Monday-Friday, 7:30a – 4pm - Ensures compliance with all state and federal billing regulations; reports any suspected compliance issues to management. - Executes client specific process flows and adheres to timelines for various follow-up processes. - Maintains a client issues list for review and resolution with the appropriate Hospital departments. - Assists with case management under FA worker’s compensation program, new hire and transfer physicals, EAP, random drug testing program, and the annual employee health surveillance. - Maintains the client base for Franciscan Working Well and develops positive client relationships, marketing the program's service. - Performs activities relevant to establishing an efficient revenue cycle in addition to monitoring aging reports in conjunction with billing service. - Submits CMV Driver examination reports on the National Registry of Certified Medical Examiners website by fulfilling the duties of a medical examiner’s administrative assistant. - Maintains follow-up procedures and working relationships with areas responsible for the information including the Medical Records Department, Patient Access, or physicians. - Manages assigned vendor inventory, ensuring accuracy and compliance with contractual agreements. - Performs at least 10 account audits monthly for each specific line of vendor business. - Performs periodic audits of contractual adjustments from vendor staff. - Processes and follows up on work denials and adjustments submitted by the vendor. - Reviews daily Recon reports. - Cash Posting experience. Qualifications - Preferred Associate's Degree - Required High School Diploma/GED - 1 year Patient Accounting Preferred - Personal Financial Specialist (PFS) Requirements - Travel is required: Never or Rarely Benefits Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org . Company Description With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.

• Perform admission screening for patients in a bed for medical necessity • Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial outcomes • Communicate with physicians, patients, members of the Healthcare team, Coordinated Business Office staff, Denial Management staff, and third-party payors to justify the admission or continued stay • Notify appropriate staff members of any admission, service, length of stay, lack of medical necessity criteria, as well as denials/appeals and issuing of letters to patients • Provide Physician, Patient, Family, Staff and Student education • Act as a resource person for the case management department regarding payer rules, regulations, policies and procedures, and utilization issues • Perform admission necessity screening using criteria as established by the various federal, state and private sector programs

• Managing client relations • Employee health duties • Occupational health program activities • Revenue cycle activities • Client account reconciliation • Client management meetings • Maintaining client issues list • Understanding various client/vendor processes for account follow-up • Proposing relevant programs • Reviewing reported client or account issues • Working proactively with clients, departments, and teams for timely resolution • Assisting with case management under FA worker’s compensation program • New hire and transfer physicals, EAP, random drug testing program, and annual employee health surveillance • Maintain the client base for Franciscan Working Well • Develop positive client relationships and market programs service • Establishing efficient revenue cycle and monitoring aging reports • Submitting CMV Driver examination reports • Maintaining follow-up procedures and working relationships with several responsible areas • Managing assigned vendor inventory • Performing account audits and periodic audits of contractual adjustments • Processing and following up on work denials and adjustments • Reviewing daily Recon reports