Physician Coding Analyst (Coding)

Accurately 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 and NC

Active 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.

Education/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).