Physician Coder (I, II, & Sr)

Coder

• Reviews medical records and codes physician services utilizing current ICD-10, CPT and HCPCS classifications systems.
• Codes diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, supplies, materials, injections, and drugs with International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), Heath Care Financing Administration Common Procedure Coding Systems (HCPCS–all levels)
• Verifies billable physician services by reviewing physician documentation for adherence to the “Physician at Teaching Hospital” rules set forth by the federal government.
• Submits to their direct management any issues or trends found within the documentation of a particular healthcare provider for evaluation and follow up.
• Collaborates with members of the specialty team to consistently monitor financial goals within their specialty to satisfy corporate goals.
• Assists with the Central Business Office to ensure appropriate and complete follow up of patient accounts to maximize reimbursement (i.e., Insurance Denials).
• Communicates effectively with physicians, physician extenders, physician offices, members of the coding team and manager.
• Utilizes resource material available in department to support accurate coding practices.
• Maintains patient confidentiality.
• Demonstrates good communication skills both verbal and written.
• Maintains 90% accuracy rate.
• Attends departmental and other meetings as scheduled.
• Provides data for production reports.
• Serves as mentor to Physician Coders I and Physician Coders II
• Serves as Management support.
• 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.

Other Related Functions

• Participates in meeting department goals.
• Maintains productivity standards as designated by management.
• Assumes responsibility for own professional growth and development through educational programs, research, etc.
• Maintains certification status.
• Performs other related duties as assigned.

Qualifications

Education/Training

• High school diploma or equivalent.
• Computer/typing literacy, knowledge of Anatomy, Physiology and Medical terminology required.
• Thorough knowledge of CPT, ICD coding as evidenced by results of coding skills test of 80% or better.
• Licensure/Certification:
• One 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.
• Physician
• Coder
• I
• Required
• Experience:
• Minimum of one (1) year coding experience in professional/physician practice coding.
• Proficient in multi-specialty
• E/M coding is preferred
• Physician
• Coder
• II
• Required
• Experience:
• Three (3) years certified coding experience in professional or physician practice coding.
• Proficiency in multi-specialty E/M coding along with minor bedside procedure coding is preferred
• Knowledge of surgical coding is desired Sr.
• Physician
• Coder
• Required
• Experience:
• Five (5) years certified coding experience in professional or physician practice coding.
• Proficiency in multi-specialty E/M coding is required
• Proficiency in multi-specialty minor bedside procedures is required
• Proficiency in (1) specialty surgical coding is required, and multi specialty surgical coding is desired