Hospital Coding Specialist III

Position Summary Remote Opportunity! At Orlando Health , we are ordinary people with extraordinary individuality, working together to bring help, healingand hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to Orlando Health patients, familiesand communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond. Position Summary Multifacility responsibility for complete and accurate coding of 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. This role aligns with billing compliance across state and federal regulations. Responsibilities Essential Functions 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 Center for Medicare and Medicaid Services (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, when possible, 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 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 level of productivity established by department. Cross train in all aspects in 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 and keep abreast of current coding changes and standards of care to maintain. Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), and adhere to official guidelines. Assure confidentiality of patient information. Maintain reasonably regular, punctual attendance consistent with Orlando Health policies, the 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 Coding certificate program Computer literacy required 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 the American Information Management Association (AHIMA) – renewed every 2 years Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) – renewed every 2 years Certified Outpatient Coder (COC) by the American Academy of Professional Coders (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 #J-18808-Ljbffr