Hospital Coding Specialist III
Remote Jobs, Orlando, FL, United States
Position Summary
Remote opportunity. Multifacility responsibility for complete and accurate coding of Same Day Surgery and Outpatient Observation for the entire Orlando Health system’s purposes of billing in compliance with State and Federal regulations.
Responsibilities
Perform review and analysis of clinical documentation and accurately assign diagnosis and procedure codes for multifacility Same Day Surgery and Outpatient Observation visits using ICD-10-CM and/or CPT-4 classification systems, utilizing EPIC Electronic Medical Record (EMR), encoder, computer assisted coding (CAC), and other applications as applicable.
Appropriately sequence diagnoses/status codes and HCPCS Level 1 and Level II CPT-4 procedure codes for proper Ambulatory Classification (APC) assignment, utilizing applicable coding conventions, Official Guidelines on Coding and Reporting, and CMS guidelines.
Communicate cooperatively and constructively with physicians, physicians’ office personnel, guests, patients, and members of the healthcare team.
Demonstrate good verbal communication skills.
Ensure procedure medical necessity coverage by complete review of provider documentation and accurate ICD-10-CM code assignment.
Accurately assign modifiers to CPT-4 procedures as applicable.
Accurately clear all applicable NCCI edits and coding validation check errors/warnings at the time of coding.
Accurately abstract information into the hospital information system.
Request additional documentation, as needed, to ensure complete accurate code assignment.
Query physicians for clarification of documentation discrepancies and inconsistencies.
Effectively collaborate with other revenue management departments for resolution of account errors or anomalies.
Work with coding teams to ensure completion of all coding within corporate goals.
Provide data for reports on statistics, optimization, productivity, etc.
Maintain 95% accuracy and participate in department QA studies.
Maintain the level of productivity established by the department.
Cross‑train in all aspects of coding based on department need.
Attend departmental and other meetings as requested.
Complete and actively participate in education activities as assigned by OH Hospital Coding Leadership.
Demonstrate knowledge and understanding of coding guidelines, procedures, medical necessity/CCI edits, and the APC reimbursement system; keep abreast of current coding changes and standards of care to maintain.
Comply with the Standards of Ethical Coding set forth by AHIMA, AAPC, and adhere to official guidelines.
Assure confidentiality of patient information.
Maintain reasonably regular, punctual attendance consistent with Orlando Health policies, ADA, FMLA, and other federal, state and local standards.
Maintain compliance with all Orlando Health policies and procedures.
Other Related Functions
Maintain established work production standards.
Work as a team member to meet department goals.
Assume the responsibility for professional growth and development through education programs, research, etc.
Qualifications Education/Training
Bachelor's or Associate’s degree.
Completed coding certificate program.
Computer literacy required.
Knowledge of medical terminology, anatomy and physiology required.
Demonstrated knowledge of coding complex outpatient surgical procedures.
Score 90% or better on Orlando Health level II coding skills test.
Licensure/Certification
Must maintain one of the following: Certified Coding Specialist (CCS); Coding Associate (CCA) by AHIMA – renewed every 2 years; Certified Professional Coder (CPC) by AAPC – renewed every 2 years; Certified Outpatient Coder (COC) by AAPC – renewed every 2 years; Registered Health Information Administrator (RHIA) – preferred but not required; Registered Health Information Technician (RHIT) – preferred but not required.
Experience
2 years previous hospital coding experience required.
Thorough knowledge of coding classification systems required.
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Responsibilities
Perform review and analysis of clinical documentation and accurately assign diagnosis and procedure codes for multifacility Same Day Surgery and Outpatient Observation visits using ICD-10-CM and/or CPT-4 classification systems, utilizing EPIC Electronic Medical Record (EMR), encoder, computer assisted coding (CAC), and other applications as applicable.
Appropriately sequence diagnoses/status codes and HCPCS Level 1 and Level II CPT-4 procedure codes for proper Ambulatory Classification (APC) assignment, utilizing applicable coding conventions, Official Guidelines on Coding and Reporting, and CMS guidelines.
Communicate cooperatively and constructively with physicians, physicians’ office personnel, guests, patients, and members of the healthcare team.
Demonstrate good verbal communication skills.
Ensure procedure medical necessity coverage by complete review of provider documentation and accurate ICD-10-CM code assignment.
Accurately assign modifiers to CPT-4 procedures as applicable.
Accurately clear all applicable NCCI edits and coding validation check errors/warnings at the time of coding.
Accurately abstract information into the hospital information system.
Request additional documentation, as needed, to ensure complete accurate code assignment.
Query physicians for clarification of documentation discrepancies and inconsistencies.
Effectively collaborate with other revenue management departments for resolution of account errors or anomalies.
Work with coding teams to ensure completion of all coding within corporate goals.
Provide data for reports on statistics, optimization, productivity, etc.
Maintain 95% accuracy and participate in department QA studies.
Maintain the level of productivity established by the department.
Cross‑train in all aspects of coding based on department need.
Attend departmental and other meetings as requested.
Complete and actively participate in education activities as assigned by OH Hospital Coding Leadership.
Demonstrate knowledge and understanding of coding guidelines, procedures, medical necessity/CCI edits, and the APC reimbursement system; keep abreast of current coding changes and standards of care to maintain.
Comply with the Standards of Ethical Coding set forth by AHIMA, AAPC, and adhere to official guidelines.
Assure confidentiality of patient information.
Maintain reasonably regular, punctual attendance consistent with Orlando Health policies, ADA, FMLA, and other federal, state and local standards.
Maintain compliance with all Orlando Health policies and procedures.
Other Related Functions
Maintain established work production standards.
Work as a team member to meet department goals.
Assume the responsibility for professional growth and development through education programs, research, etc.
Qualifications Education/Training
Bachelor's or Associate’s degree.
Completed coding certificate program.
Computer literacy required.
Knowledge of medical terminology, anatomy and physiology required.
Demonstrated knowledge of coding complex outpatient surgical procedures.
Score 90% or better on Orlando Health level II coding skills test.
Licensure/Certification
Must maintain one of the following: Certified Coding Specialist (CCS); Coding Associate (CCA) by AHIMA – renewed every 2 years; Certified Professional Coder (CPC) by AAPC – renewed every 2 years; Certified Outpatient Coder (COC) by AAPC – renewed every 2 years; Registered Health Information Administrator (RHIA) – preferred but not required; Registered Health Information Technician (RHIT) – preferred but not required.
Experience
2 years previous hospital coding experience required.
Thorough knowledge of coding classification systems required.
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