Physician Coding Education Specialist

Title: Physician Coding Education Specialist

Location: Orlando, FL United States

• Patient Accounting & Patient Access
• Orlando Health Medical Group
• Day
• 227056

Job Description:
Position Summary

Orlando Health Medical Group is a comprehensive physician group serving patients from across the southeastern United States. With more than 200 practices and 1,200 physicians, Orlando Health Medical Group has a strong representation in over 55 specialties, including cardiology, vascular medicine, orthopedics, oncology, digestive health, neurology, neurosurgery, bariatric surgery, general surgery, bone marrow transplant and critical care medicine, as well as more than 30 pediatric subspecialties, women’s health, primary care and the largest hospitalist program in Florida.

Orlando Health Medical Group is part of the Orlando Health system of care, which includes 24 award-winning hospitals and ERs, 9 specialty institutes, 14 urgent care centers, 100+ primary care practices and more than 60 outpatient facilities that span Florida’s east to west coasts and beyond. Collectively, we honor our 100-year legacy by providing care for more than 142,000 inpatient and 3.9 million outpatient visits each year.

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.

Job Summary

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 educations that will contribute to effective productivities.

**This opportunity is a hybrid role , for the Orlando Market.

Patient Accounting -Physicians Department 
Responsibilities

Essential Functions
• Responsible for internal auditing and analyzing professional coding for all service lines.
o Will monitor the audit results closely to identify any potential coding inaccuracy
o Gives the Department the needed support in identifying coding errors
o Gives the practice the security that we are capturing the service accordingly
o Gives providers additional education when needed and requested.
▪ Ensure that medical documentation is following Governmental payers, Managed Care and private insurances 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.
• Ability to identify and communicate physician documentation and coding opportunities for improvement
• Takes an active role in developing and presenting educational programs to physicians, physician extenders, and physician offices.
• Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members of the Physician and Professional Services Central Business Office.
• Takes the initiative to identify and solve 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.
• Collaborates with Physician and Professional Services Central Business Office 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 statistical reports to deliver accurate documentation of ongoing internal coding efficiency process.
• Conducts focused physician reviews as needed and provides data to manager.
• Maintains 90% physician coding accuracy rate.
• Attends payor, departmental and interdepartmental meetings as required.
• Prepares/distributes information summarizing opportunities with physician coding monthly.
• 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 preceptor to new coders
Qualifications

Skills Knowledge
• Excellent knowledge of CPT-4, ICD-10-CM/PCS and HCPCS coding principles, governmental regulations, protocols, and third party payer requirements pertaining to billing, coding and documentation
• Knowledge of medical terminology
• Experience working with Electronic Medical Records
• Ability to work independently
• Strong interpersonal and presentation skills paired with advanced written and verbal communication skills
• Strong analytical and writing skills required for proposal and report development

Education/Training
• Associate degree required. Three (3) years of directly related work experience may substitute for the associate degree.
• Possesses exceptional knowledge in Microsoft Office Word, Outlook, and PowerPoint as well as moderate to expert experience with Microsoft Excel.
• 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 maintain 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 Medical Coder (CMC) through Practice Management Institute
• Additional CPMA or COC certification is preferred

Experience
• 5-6 years of professional based coding experience is required.
• Professional based coding experience must include all types – Clinic, Behavior Health, hospital rounding, SDS, Teaching & Physician extender provider coding, All specialties