Orlando Health
MUST RESIDE IN ST PETE, FL AREA
At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we have grown into a 3,900-bed healthcare organization that delivers care for more than 142,000 inpatient and 3.9 million outpatient visits each year. Our 24 award-winning hospitals and ERs, 9 specialty institutes, 14 urgent care centers, 100+ primary care practices and more than 60 outpatient facilities serve communities that span Florida’s east to west coasts and beyond.
Orlando Health is committed to providing you with benefits that go beyond the expected, with career‑growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.
Position Summary The Physician Coding Ed Specialist performs, develops, and implements coding‑related efficiency processes to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Education Specialist is responsible for analyzing physician coding trends and providing education that will contribute to effective productivities.
The role requires a hybrid working model with 90% remote and 10% on‑site, full‑time exempt position, Monday through Friday with day shift (flextime with occasional early/late hours).
Responsibilities
Responsible for internal auditing and analyzing professional coding for all service lines.
Monitor audit results closely to identify any potential coding inaccuracies and provide support to departments/practices to identify and correct coding errors.
Ensure medical documentation follows governmental payer, managed care, and private insurance guidelines.
Review medical records to ensure accuracy of code assignment.
Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.
Identify and communicate documentation and coding improvement opportunities.
Take an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
Effectively communicate best practice physician coding feedback with physicians, non‑physician providers, office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
Identify and solve complex trending coding issues affecting the physician revenue cycle and provide feedback to correct claims and recover underpaid amounts.
Collaborate with the physician and professional services central business office to ensure appropriate follow‑up of patient accounts for coding accuracy.
Maintain 90% physician coding accuracy rate.
Prepare and distribute monthly summaries of coding opportunities to physicians and practice managers.
Research, identify, and implement plans to resolve coding disputes with payors.
Utilize resource materials from CMS, AMA, AHCA and federal registries to support coding practices.
Perform physician queries for coding and documentation clarification during concurrent chart review.
Serve as a preceptor to new coders and provide ongoing educational programs to the coding team and manager.
Maintain confidentiality of patient and coder data.
Adhere to standards of ethical coding and all applicable regulations and guidelines.
Perform other tasks as assigned based on company needs and projects.
Qualifications
Associate degree required or five (5) years of directly related work experience may substitute.
Excellent knowledge of CPT‑4, ICD‑10‑CM/PCS, HCPCS coding principles, government regulations, and third‑party payer requirements pertaining to billing, coding, and documentation.
Knowledge of medical terminology and experience working with Electronic Medical Records.
Ability to work independently and strong interpersonal, presentation, written, and verbal communication skills.
Strong analytical and report writing skills required for proposal and report development.
Proficiency in Microsoft Office Word, Outlook, and PowerPoint; moderate to expert experience with Microsoft Excel.
Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS evidenced by successful coding skills test with 90% or better.
Must maintain one of the following national certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist‑Physician (CCS‑P), Certified Medical Coder (CMC), Certified Professional Medical Auditor (CPMA), or CEMA certification via National Alliance of Medical Auditing Specialists.
5–6 years of professional‑based coding experience, including office, inpatient, bedside procedures, surgical coding, teaching & physician extender provider coding, multiple specialties desired; Level One Trauma hospital experience preferred; experience with large, multi‑location, multi‑specialty high‑volume organization preferred.
Other Related Functions
Attend payor, departmental and interdepartmental meetings as required.
Other duties as assigned based on organization and project needs.
Collaborate for testing, training, and mentoring incoming coders according to coding guidelines and individual skills.
Conduct focused physician reviews as needed and provide data to manager.
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At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we have grown into a 3,900-bed healthcare organization that delivers care for more than 142,000 inpatient and 3.9 million outpatient visits each year. Our 24 award-winning hospitals and ERs, 9 specialty institutes, 14 urgent care centers, 100+ primary care practices and more than 60 outpatient facilities serve communities that span Florida’s east to west coasts and beyond.
Orlando Health is committed to providing you with benefits that go beyond the expected, with career‑growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.
Position Summary The Physician Coding Ed Specialist performs, develops, and implements coding‑related efficiency processes to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Education Specialist is responsible for analyzing physician coding trends and providing education that will contribute to effective productivities.
The role requires a hybrid working model with 90% remote and 10% on‑site, full‑time exempt position, Monday through Friday with day shift (flextime with occasional early/late hours).
Responsibilities
Responsible for internal auditing and analyzing professional coding for all service lines.
Monitor audit results closely to identify any potential coding inaccuracies and provide support to departments/practices to identify and correct coding errors.
Ensure medical documentation follows governmental payer, managed care, and private insurance guidelines.
Review medical records to ensure accuracy of code assignment.
Guide and educate coding team members by addressing errors, performance issues, and trends identified through reporting.
Identify and communicate documentation and coding improvement opportunities.
Take an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
Effectively communicate best practice physician coding feedback with physicians, non‑physician providers, office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
Identify and solve complex trending coding issues affecting the physician revenue cycle and provide feedback to correct claims and recover underpaid amounts.
Collaborate with the physician and professional services central business office to ensure appropriate follow‑up of patient accounts for coding accuracy.
Maintain 90% physician coding accuracy rate.
Prepare and distribute monthly summaries of coding opportunities to physicians and practice managers.
Research, identify, and implement plans to resolve coding disputes with payors.
Utilize resource materials from CMS, AMA, AHCA and federal registries to support coding practices.
Perform physician queries for coding and documentation clarification during concurrent chart review.
Serve as a preceptor to new coders and provide ongoing educational programs to the coding team and manager.
Maintain confidentiality of patient and coder data.
Adhere to standards of ethical coding and all applicable regulations and guidelines.
Perform other tasks as assigned based on company needs and projects.
Qualifications
Associate degree required or five (5) years of directly related work experience may substitute.
Excellent knowledge of CPT‑4, ICD‑10‑CM/PCS, HCPCS coding principles, government regulations, and third‑party payer requirements pertaining to billing, coding, and documentation.
Knowledge of medical terminology and experience working with Electronic Medical Records.
Ability to work independently and strong interpersonal, presentation, written, and verbal communication skills.
Strong analytical and report writing skills required for proposal and report development.
Proficiency in Microsoft Office Word, Outlook, and PowerPoint; moderate to expert experience with Microsoft Excel.
Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS evidenced by successful coding skills test with 90% or better.
Must maintain one of the following national certifications: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist‑Physician (CCS‑P), Certified Medical Coder (CMC), Certified Professional Medical Auditor (CPMA), or CEMA certification via National Alliance of Medical Auditing Specialists.
5–6 years of professional‑based coding experience, including office, inpatient, bedside procedures, surgical coding, teaching & physician extender provider coding, multiple specialties desired; Level One Trauma hospital experience preferred; experience with large, multi‑location, multi‑specialty high‑volume organization preferred.
Other Related Functions
Attend payor, departmental and interdepartmental meetings as required.
Other duties as assigned based on organization and project needs.
Collaborate for testing, training, and mentoring incoming coders according to coding guidelines and individual skills.
Conduct focused physician reviews as needed and provide data to manager.
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