Physician Coding Ed Specialist

• Location: Hybrid, Remote 90% & On-site 10%
• Status: Full Time (exempt)
• Days: Monday through Friday
• Shift: Day (flextime plan with the possibility of occasional early morning/evening hours)

• Responsible for internal auditing and analyzing professional coding for all service lines.

• Review medical recordsto ensure accuracy of code assignment.
• Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.
• Identify and communicate physician documentation and coding opportunitiesforimprovement
• Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
• Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
• Takes the initiative to identify and solve complex trending coding issues affecting the physician revenue cycle and provide the necessary feedback to correct claims on a go-forward basis as well as recovered underpaid amounts.
• Collaborates with Physician and Professional Services Central Business Office to ensure appropriate and complete follow up of patient accounts to ensure coding accuracy for payor guideline reimbursement.
• Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress.
• Providesstatisticalreportsto deliver accurate documentation of ongoing internal coding efficiency process.
• Conducts focused physician reviews as needed and provides data to manager.
• Maintains 90% physician coding accuracy rate.
• Attends payor, departmental and interdepartmentalmeetings asrequired.
• Prepares/distributes information summarizing opportunities with physician coding monthly.
• Researches, identifies, develops, and assistsin implementation of a plan of action to resolve coding disputes with payors.
• Utilizesresource material available in department, CMS, AMA, and AHCA and federal registry to support coding practices.
• Perform physician queriesfor coding and documentation clarification during concurrent chartreview process.
• Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress.
• Serves as a preceptor to new coders.
• Takes an active role in developing and presenting educational programs to Physician & Professional Services team, physicians, physician extenders, physician offices, and all members of the coding team and manager.

• Maintains patient and coder confidentiality results.
• 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 clientspecific policies.
• Other duties as assigned based on company needs and projects.
• Ongoing Coding Education and training activities
• Responsible for the development and training of staff within the scope of his/her responsibilities as it relates to Coding Department structure

• Develop and implement coder enhancementstrategies

• Provide daily support to all assigned practice managers on their coding related questions
• 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 asrequired.
• 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. Qualifications:

• Excellent knowledge of CPT-4, ICD-10-CM/PCS and HCPCS coding principles, governmental regulations, protocols, and thirdparty payer requirements pertaining to billing, coding and documentation
• Knowledge of medical terminology
• Experience working with Electronic Medical Records
• Ability to work independently
• Strong interpersonal and presentation skills paired with advanced written and verbal communication skills
• Strong analytical and writing skillsrequired for proposal and report development

• Associate degree required.

• Five (5) years of directly related work experience may substitute for the associate degree.
• Possesses exceptional knowledge in Microsoft Office Word, Outlook, and PowerPoint as well as moderate to expert experience with Microsoft Excel.
• Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90% or better.

• Certified Professional Coder (CPC) through the American Academy of Professional Coders
• Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA)
• Certified Coding Specialist-Physician (CCS-P) through the American Health Information Management Association (AHIMA)
• Certified Medical Coder (CMC) through Practice Management Institute
• Certified Professional Medical Auditor (CPMA)
• CEMA certification via National Alliance of Medical Auditing Specialists

• 5-6 years of professional based coding experience isrequired.
• Professional based coding experience must include – Office, Inpatient, Bedside Procedures, Surgical Coding, Teaching &

• Level one (1) Trauma hospital experience is preferred.
• Experience with a large organization, multi-location, multi-specialty with high volume providers is preferred.

Orlando Health