Physician Coding Auditor
- Florida
- Permanent
- Full-time
- Evening, nights, and weekend shift differentials offered for qualifying positions.
- Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.
- Forbes has named Orlando Health as one of America's Best-In-State Employers for 2021. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.
- Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare.
- Responsible for internal auditing and analyzing professional coding for all service lines.
o Provides the Educators the needed support in identifying coding errors.
o Provides results or trends with Education Team for physician education.
- Review medical records to ensure coding accuracy.
- Identify and communicate physician documentation and coding opportunities for improvement.
- Provides feedback to physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office regarding best practices to ensure physician coding compliance.
- Collaborates with Physician Coding Education Team to ensure appropriate and complete coding accuracy for payor guideline reimbursement.
- Utilizes resource material available in department, CMS, AMA, AHCA and federal registry to support coding practices.
- Maintains patient and coder confidentiality audit results.
- Collaborate with physician coding leadership for monitoring coding quality.
- Participate in Health Plan Audits
- Follow and adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
- Perform physician queries for coding and documentation clarification during concurrent chart review process.
- Serves as a resource to new coders.
- Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress.
- Proficiency in coding including ICD-10, CPT, E/M, modifiers while maintaining a 90% accuracy.
- Adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
- Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state, and local standards.
- Maintains compliance with all Orlando Health policies and procedures.
- Attends payor, departmental and interdepartmental meetings as required.
- Other duties as assigned based on organization needs and projects.
- Works in collaboration for testing, training, and mentoring incoming coders according to the coding guidelines and individual skills for the Division for which the coder will be assigned.
- Conducts focused physician reviews as needed and provides data to manager.
- High School diploma or equivalent
- Possesses exceptional knowledge in Microsoft Office Suite
- Thorough knowledge of official coding guidelines as per AMA, AHCA, and CMS as evidenced by results of coding skills test of 90% or better.
Must maintain one (1) of the following nationally recognized certifications:
- CPMA certification required through the American Academy of Professional Coders
- Coding Credential Required: AHIMA or AAPC credential.
- CEMA certification via National Alliance of Medical Auditing Specialists
- Five (5+) years of professional based coding experience in multiple specialties is required.
- Strong research, organizational, multi-tasking, planning, problem-solving and critical thinking skills
- Excellent collaboration, verbal, and written communication skills with providers, leadership, and team members
- Excellent knowledge of medical terminology, CPT, ICD-10-CM/PCS and HCPCS coding principles, governmental regulations, protocols, and third-party payer requirements pertaining to billing, coding, and documentation
- Expert Coding (CPT and ICD-10-CM) and auditing
- Experience working with Electronic Medical Records, EPIC experience preferred
- Excellent communication (written and oral) and interpersonal skills.
- Strong organizational, multi-tasking, and time-managementskills.
- Must be detail oriented and able to follow through on issues to resolution.
- Must be able to act both independently and as a team member.
- Ability to work independently