Professional Coder 3

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The Department of HIM has an exciting opportunity for a full-time Professional Coder 3 to work in Miami, FL.    Medical coders help to complete, review, and process medical claims to help physician practices and hospitals get reimbursed from insurance companies for services and facilities provided to patients.

A Professional Coder 3 at the University of Miami is responsible for reviewing the clinical documentation contained in the UHealth patient health records (regardless of medium in which the patient documentation is maintained) to validate the codes assigned by physicians. Abstract and or validates as necessary, abstract E&M, and Procedure codes for surgical specialties, Dermatology, Interventional Radiology and/or Interventional Cardiology, Neurosurgery, Ophthalmology, Orthopedics, Trauma and Transplant, and other specialties that are predominantly invasive codes for medical specialties including Ancillary, Non-Surgical and Surgical services. Has a thorough understanding of ICD-10-CM diagnosis, CPT with E&M and procedural codes used in reimbursement and data collection.                                                                                                    

• Identifies incomplete documentation and seeks clarification from the responsible physician.  Identifies misplaced or potentially conflicting documentation and reports findings to appropriate party for action.

• Verifies patient information to identify any documentation and/or report discrepancies and to ensure codes and other abstracted data are accurately applied to appropriate patient’s account/encounter.

• While reviewing the record for coding validation purposes, serves as quality reviewer of scanned documents.  Identifies mis-scans: poorly scanned documents, and misplaced documentation; promptly reports findings to the Professional Coding Manager

• Assesses documentation and/or queries physician for additional information when indicated to clarify or provide specificity to a diagnosis, symptom, or reason for services provided to ensure the organization receives its entitled reimbursement for care provided.  Collaborates with others in the organization including medical staff and other clinicians to ensure the record accurately documents the services provided and to identify documentation trends that can prospectively address deficiencies.

• When necessary, accurately assign and sequences ICD-10-CM diagnosis and/or CPT E&M and procedural codes to professional encounters.

• Adheres to University and unit-level policies and procedures and safeguards University assets.

• Establishes and continuously assesses the effectiveness of the internal controls within the unit and compliance with university policies and procedures. Ensures employees are trained in controls within the function and on university policy and procedures.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities, as necessary.

MINIMUM QUALIFICATIONS                                                                                                         

• High school diploma and an equivalent of 5 years of professional coding experience.

• Minimum 5 years of relevant experience

• Certified Coding Associate (CCA), Certified Professional Coder (CPC; CPC-A), Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician Office (CCS-P)

• OR Registered Health Information Technician (RHIT) Certified Coding Associate (CCA), Certified Professional Coder (CPC; CPC-A), Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician Office (CCS-P)

• Understanding of and adherence to the Health Insurance Portability and Accountability Act (HIPAA).

• Supports the philosophy, objectives, and goals of UHealth and the Health Information Management department by volunteering in various capacities without compromising performance expectations.

• Demonstrates knowledge of and compliance with the UHealth Compliance Program, Policies and Procedures, and Safety Policies and Procedures.

• Abides by standards of the American Health Information Management Association’s professional and ethical conduct.

• Contributes to the efficiency of the UHealth Health Information Management

• Remains current with continuing education requirements to maintain credentials.

• Demonstrates ability to work independently and/or in a collaborative environment.

• Displays efficient and effective communication skills (interpersonal, verbal, and written).

• Demonstrate critical thinking, organizational, and analytical skills, as well as the ability to interpret, assess, and evaluate provider documentation.

• Proficient with Microsoft Office applications.

• Ability to sit for extended periods of time.

• Capable of working in a 100% remote environment with minimal supervision, while also staying focused on assigned tasks.

Department Specific Functions

The Ancillary, Non-Surgical and Surgical Coder 3: follows all functional area standard operating procedures.

• Achieves and maintains quality expectations of 95% accuracy for both coding and abstracting and productivity expectations for encounters.

• Reviews assigned coder work queue and follows standard process of opening the charge session, reviewing edits, clearing edits by checking documentation associated in the chart for those identified services, and reviews the notes (i.e., documentation for that date of service). 

• Demonstrate knowledge of modifiers and application of appropriate modifier if needed (i.e.,24,25,57) 

• If there is missing documentation, follow Deficiency standard operating procedure.

• Validate charge session and assign date/name confirming ownership of charge review.

• Ensures all encounters are coded/validated within 5 days of service date (or other benchmark set by Department) by collaborating with physicians and mid-level staff.

• Meets coding validation/charge entry productivity expectations established by the department.

• Routinely volunteer to assist others when his/her work is completed.

• Converts the documented clinical information into applicable diagnostic and procedure codes. Codes and abstracts medical records to provide information for financial reimbursement, meaningful use, state and federal registries, and strategic planning data collection purposes.

• Educates physicians and other clinicians on documentation issues and coding idiosyncrasies.

Schedule/Mobility Requirements:

100% Remote

40 hours per week, Monday through Friday, during regular business hours

Travel – None

The University of Miami offers competitive salaries and a comprehensive benefits package including medical, dental, tuition remission and more.

UHealth-University of Miami Health System, South Florida's only university-based health system, provides leading-edge patient care powered by the ground breaking research and medical education at the Miller School of Medicine. As an academic medical center, we are proud to serve South Florida, Latin America and the Caribbean. Our physicians represent more than 100 specialties and sub-specialties, and have more than one million patient encounters each year. Our tradition of excellence has earned worldwide recognition for outstanding teaching, research and patient care. We're the challenge you've been looking for.

Patient safety is a top priority. As a result, during the Influenza ("the flu") season (September through April), the University Of Miami Miller School Of Medicine requires all employees who provide ongoing services to patients, work in a location (all Hospitals and clinics) where patient care is provided, or work in patient care or clinical care areas, to have an annual influenza vaccination. Failure to meet this requirement will result in rescinding or termination of employment.

The University of Miami is an Equal Opportunity Employer - Females/Minorities/Protected Veterans/Individuals with Disabilities are encouraged to apply. Applicants and employees are protected from discrimination based on certain categories protected by Federal law. Click here for additional information.

Job Status:

Full time

Employee Type:

Staff

Pay Grade:

H8