Coding Validation Specialist 3

Inova Health is a nationally ranked healthcare leader in safety, quality, and patient experience, recognized as a top employer in the D.C. metro area and the nation.

About Us

We are Inova, Northern Virginia’s leading nonprofit healthcare provider. Our 26,000+ team members deliver world-class healthcare and are supported through best-in-class facilities and professional development opportunities.

About the Role

Full-time, remote position with general office hours, Monday–Friday.

Responsibilities

• Code and review assigned records with defined productivity standards: four charts per hour for complex/intermediate surgeries and five charts per hour for simple surgeries.
• Actively participate in internal pre-bill coding audits, independent coding audits, and coding education sessions.
• Enhance professional growth and development through relevant continuing education activities.
• Maintain or surpass Inova Health System-defined quality standards for accurate assignment and validation of Evaluation and Management (E/M) at 95% accuracy.
• Ensure correct CPT code for the level of service billed (e.g., Place of Service, Observation codes for Observation Status, Inpatient Codes for Inpatient Status).
• Change consult codes based on payer requirements to the appropriate E/M code, units, and/or modifiers, maintaining 95% or greater accuracy.
• Verify the accuracy, completeness, and quality of ICD-10-CM, CPT-4, and HCPC coding, including modifiers, units, and other variables impacting workload accountability and billing.
• Communicate with responsible physicians or mid-level providers to obtain additional supporting documentation or clarification required for code assignments, including escalation or secondary review as necessary.

Requirements

• High School diploma or GED.
• Three years of coding experience.
• One of the following certifications: RHIT, CCS, CPC, COC, or CCS-P.

Preferred Qualifications

• Strong general surgery coding experience.

Benefits

• Committed to Team Member Health: Medical, dental, and vision coverage, plus 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: Up to $5,250 per year in education assistance and up to $10,000 for student loans.
• Mental Health Support: 25 mental health coaching or therapy sessions per year at no cost for team members, their spouses/partners, and children.
• Work/Life Balance: Paid time off, paid parental leave, flexible work schedules, and remote/hybrid career opportunities.