Clinical Coder I

Clinical Coder 1

• The Department of Orthopaedics is seeking a clinical coder to join our dynamic team! This position will assure that services are captured, coded and billed accurately, analyzes and codes diagnostic and procedural information that determines insurance payment. The incumbent also assists in training physicians and staff regarding documentation, billing and coding practices.

Responsibilities include:

• Reviews daily Evaluation and Management (E&M) charges pending in E&M workqueue. Responsible for resolving charge review edits related to registration, insurance and authorizations. Reconcile daily operating room (OR) schedule and cross-reference the charge in the surgical workqueue. Reviews surgical cases for missing documentation or errors regarding the operative notes or case attestation. Review missing charge report twice per week for any missing charges.  Must review case in EPIC to determine if surgery case was actually completed or cancelled.  Communicate to providers any charges not submitted.  Reports any issues back to supervisor regarding billing and coding edits.  Reviews codes assigned by physicians, or assign the appropriate, ICD-10, ICD-9 and CPT codes based on reports and/or progress notes provided by physicians.  Assist providers with coding education and feedback to improve their accuracy in code selection.
  
•  Ensure continuous quality improvement of physician coding and team billing practices.  This includes review of and recommendations for ICD-10; ICD9/CPT coding to ensure compliance with policies for coding and claim submission.

• Monitor that reimbursement levels are appropriate, especially in areas that are at risk for improper reimbursement.  Analyze and propose opportunities in the managed care contracting process.

• Ensure clean claim submission by resolving system edits for inpatient and outpatient hospital services and doctor's office edits when applicable.  Review and analyze rejections to determine trends; propose solutions for change in process as appropriate.  Identify payer-specific trends and provide support to resolve claim issues.

• Participate in group discussions and problem resolution activities pertaining to the division and department; proactively serve as a resource for providers for coding/compliance issues.  Work collaboratively with providers, peers, payers and others.

• Track and resolve provider enrollment issues for new providers.  Work with others to ensure that billing numbers are received and A/R is released for timely payment.

• Demonstrate a working knowledge of Managed Care processes.  Stay abreast of annual coding updates.

$20 - $23 per hour, commensurate with qualifications. 

High school diploma or equivalent.  Incumbent will be required to obtain professional coding certification within the first 6 months of employment.  Approved certifications: Certified Professional Coder (CPC), American Academy of Professional Coders (AAPC), Certified Outpatient Coder (COC), Certified Compliance Professional-Physician (CCP-P) or Certified Coding Specialists (CCS-P) required.

Preferred Qualifications include:

• Prior experience working in a healthcare environment
• Advanced knowledge of medical terminology
• Professional coding certification.  Certified Professional Coder (CPC), American Academy of Professional Coders (AAPC), Certified Outpatient Coder (COC), Certified Compliance Professional-Physician (CCP-P) or Certified Coding Specialists (CCS-P) required
• Demonstrate ease with learning new programs
• Ability to multitask
• Ability to prioritize work and proceed with minimal supervision
• Ability to maintain a professional approach at all times and function in a team environment
• Must be able to communicate effectively both verbally and in writing

In order to be considered, you must upload your cover letter, a list of 3 professional references and resume.

The University of Florida is committed to non-discrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, gender identity and expression, marital status, national origin, political opinions or affiliations, genetic information and veteran status in all aspects of employment including recruitment, hiring, promotions, transfers, discipline, terminations, wage and salary administration, benefits, and training.

This position is eligible for veteran’s preference. If you are claiming veteran’s preference, please upload a copy of your DD 214 Member Copy 4 with your application for consideration. See our Veteran's
Preference Page for more specific information.

This requisition has been reposted. Previous applicants are still under consideration and need not apply.

Review of applications will begin 3/13/2024 and will continue until a suitable applicant pool has been established.