Physician Coding Analyst | Orlando Health

Job title: Physician Coding Analyst

Company: Orlando Health

Job description: Job Description:Position SummaryAccurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services.Candidates are eligible to work remote from the listed states: FL, GA, AZ, TX, AL
ResponsibilitiesActive involvement with internal auditors, educators and denials team for analyzing professional coding for assigned service lines and divisional coders.
o Supports coders in identifying educational needs and growth
o Provides leadership support for education when needed and requested.

• Active production coding to review medical records to ensure accuracy of code assignment.
• Provides guidance and support to Coder I, Coder II and Coder Sr for any necessary questions or cases.
• Identifies and solves 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.
• Analyzes trending of work queue volumes and prioritization.
• Submits to their direct management any issues or trends found within the documentation of a particular healthcare provider for evaluation and follow up and any issues or trends found within the designated EMR that can potentially be enhanced for workflow effectiveness.
• Collaborates with Coding Denial Manager, Coding Operations Manager and Coding Education & Auditing Manager 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.
• Provides occasional reporting to deliver accurate documentation of internal coding enhancements.
• Acts as subject-matter expert regarding upcoming developed procedural and diagnostic coding and as a knowledgeresource for internal and external queries.
• Attends payor, departmental and interdepartmental meetings, as required.
• Researches, identifies, develops, and assists in implementation of a plan of action to resolve coding disputes with payors.
• Utilizes resource material available in department, CMS, AMA, and AHA to support coding practices.
• Serves as a mentor to new team members.
• Provides training to new onboarding team members, when necessary.
• Maintains patient confidentiality.
• Follows and adheres to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
• Provides daily support to all assigned practice managers on their coding related questions, when necessary.
• Monitors documentation and coder delinquent accounts and provide updates to management.
• Serves as a subject matter expert in clinical documentation and coding best practices for both internal and external partners.
• Be an active participant in prospective program development, execution, and performance.
• Other duties as assigned based on company needs and projects.
• 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.
• Performs all other duties as assigned.

Other Related Functions

• Excellent knowledge of CPT, ICD-10 and HCPCS coding principles, governmental regulations, protocols, and third-party payer requirements pertaining to billing, coding and documentation.

Proficiency in coding including ICD-10, CPT, E/M, HCPCS, and modifiers while maintaining a 90% accuracy.

• Advanced knowledge of medical terminology.
• Ability to address related and complex matters independently related to coding guidelines prior to referral to Management, Educator or Auditor
• Maintains 90% physician coding accuracy rate.
• Ability to identify and communicate physician documentation and coding opportunities for improvement.
• Ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.
• Requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision
• Preferred experience working with Electronic Medical Records (EPIC).
• Ability to work independently with strong organizational skills.
• Positive attitude and ability to be a team player.
• Strong written and verbal communication skills.
• Strong investigative and writing skills required for proposal and report development.

QualificationsEducation/Training

• Associate degree or three (3) years of directly related work experience as a Sr Physician Coder (or position title equivalent) may substitute for the associate degree.
• Possesses exceptional knowledge in Microsoft Office, Word and Outlook, with preferred knowledge of PowerPoint as well as moderate experience with Microsoft Excel and TEAMS.
• Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90% or better.

Licensure/Certification
Must hold and maintain at least one (1) of the following national certifications:

• 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 Coding Associate (CCA) through the American Health Information Management Association (AHIMA)
• Certified Medical Coder (CMC) through Practice Management Institute

Experience

• Minimum of 6+ years of professional/physician-based coding experience is required.
• Professional based coding experience must include at least – Office, Inpatient, Bedside and/or surgical procedures, Teaching

& Physician extender provider coding, multiple specialties is preferred.

• Level one (1) Trauma hospital experience is preferred.
• Experience with a large organization, multi-location, multi-specialty with high volume providers is preferred.
• 3+ years previous experience as a Sr Physician Coder (or position title equivalent).

Expected salary:

Location: Orlando, FL

Job date: Fri, 21 Feb 2025 08:32:09 GMT

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