Position Summary Remote Opportunity! At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healingand hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, familiesand communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members 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 SummaryMultifacility responsibility for complete and accurate coding of Same Day Surgery and Outpatient Observation for entire Orlando Health system’s purposes of billing in compliance with State and Federal regulations. Responsibilities Essential Functions•Perform review and analysis of clinical documentation and accurately assign diagnosis and procedure codes for multifacility Same Day Surgery and Outpatient Observation visits using ICD-10-CM and/or CPT-4 classification systems+, utilizing EPIC Electronic Medical Record (EMR), encoder, computer assisted coding (CAC), and other applications as applicable.•Appropriately sequence diagnoses/status codes and HCPCS Level 1 and Level II CPT-4 procedure codes for proper Ambulatory Classification (APC) assignment, utilizing applicable coding conventions, Official Guidelines on Coding and Reporting, and Center for Medicare and Medicaid Services (CMS) guidelines.•Communicates cooperatively and constructively with physicians, physicians’ office personnel, guests, patients, and members of the healthcare team.•Demonstrates good verbal communication skills.•Ensure procedure medical necessity coverage, when possible, by complete review of provider documentation and accurate ICD-10-CM code assignment.•Accurately assign modifiers to CPT-4 procedures as applicable.•Accurately clear all applicable NCCI edits and coding validation check errors/warnings at the time of coding.•Accurately abstracts information into hospital information system.•Request additional documentation, as needed, to ensure complete accurate code assignment.•Query physicians for clarification of documentation discrepancies and inconsistencies.•Effectively collaborate with other revenue management departments for resolution of account errors or anomalies.•Works with coding teams to ensure completion of all coding within corporate goals.•Provides data for reports on statistics, optimization, productivity, etc.•Maintains 95% accuracy and participates in department QA studies.•Maintains level of productivity established by department.•Cross trains in all aspects in coding based on department need.•Attends departmental and other meetings as requested.•Completes and actively participates in education activities as assigned by OH Hospital Coding Leadership.•Demonstrates knowledge and understanding of coding guidelines, procedures, medical necessity/CCI edits and the APC reimbursement system and keeps abreast of current coding changes and standards of care to maintain.•Complies with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), and adheres to official guidelines•Assures confidentiality of patient information.•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• Maintains established work production standards.• Works as a team member to meet department goals.• Assumes the responsibility for professional growth and development through education programs, research, etc. Qualifications Education/Training•Bachelor’s or Associates degree; ORoCoding certificate programoComputer literacy requiredoMedical terminology, anatomy and physiology required oDemonstrated knowledge of coding complex outpatient surgical proceduresoScore 90% or better on Orlando Health level II coding skills test Licensure/CertificationMust maintain one of the following:•Certified Coding Specialist (CCS)•Coding Associate (CCA) by the American Information Management Association (AHIMA) – renewed every 2 years•Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) – renewed every 2 years.•Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) – renewed every 2 years.•Registered Health Information Administrator (RHIA) – preferred but not required•Registered Health Information Technician (RHIT) – preferred but not required Experience•2 years previous hospital coding experience required.•Thorough knowledge of coding classification systems required.

Additional Information About the Role BJC is hiring for an Inpatient Coder I. This is a remote position. Must have one of the following certifications: - CCS or CCA or RHIA or RHIT Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development. BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country. Preferred Qualifications Role Purpose The Inpatient Coder I assigns diagnosis and procedure codes for inpatient encounters, while adhering to all regulatory guidelines. Responsibilities - Accurately abstracts data elements as required. - Stays current of all changes in coding conventions, regulatory guidelines, code updates and BJC coding guidance. - Thoroughly reviews and analyzes patient encounters for compliant coding. Queries provider for clarification or additional information as required. - Accurately assigns codes in a timely manner. Interprets, assesses and evaluates provider documentation for appropriate DRG assignment. - Effectively collaborates with leadership, colleagues and customers (CDI, HIM Operations, and other departments) as appropriate to ensure the integrity of the medical record and coding compliance. Minimum Requirements Education - High School Diploma or GED Experience - No Experience Supervisor Experience - No Experience Licenses & Certifications - Cert/Lic in Area of Expertise - CCS or CCA or RHIA or RHIT Preferred Requirements Experience - 2-5 years Benefits and Legal Statement BJC Total Rewards At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being. - Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date - Disability insurance* paid for by BJC - Annual 4% BJC Automatic Retirement Contribution - 401(k) plan with BJC match - Tuition Assistance available on first day - BJC Institute for Learning and Development - Health Care and Dependent Care Flexible Spending Accounts - Paid Time Off benefit combines vacation, sick days, holidays and personal time - Adoption assistance To learn more, go to our Benefits Summary *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer

JOB DESCRIPTION Job Summary Responsible for accurate and timely intake and interpretation of regulatory and/or functional requirements related to but not limited to coverage, reimbursement, and processing functions to support systems solutions development and maintenance. This role includes coordination with stakeholders and subject matter experts on partnering teams and supporting governance committees where applicable. JOB DUTIES - Develops and maintains requirement documents related to coverage, reimbursement and other applicable system changes in areas to ensure alignment to regulatory baseline requirements and any health plan developed requirements. - Monitors sources to ensure all updates are aligned. - Leads coordinated development and ongoing management /interpretation review process, committee structure and timing with key partner organizations. - Conducts analysis to identify root causes and assist with problem management as it relates to state requirements. - Communicates requirement interpretations and changes to health plans/product team and various impacted corporate core functional areas for requirement interpretation alignment and approvals as well as solution traceability through regular meetings and other operational process best practices. - Provides support for requirement interpretation inconsistencies and complaints. - Self-organized reporting to ensure health plans/product team and other leadership are aware of work efforts and impact for any prospective or retrospective requirement changes that can impact financials. - Engages with operations leadership and Plan Support functions to review compliance-based issues for benefit planning purposes. KNOWLEDGE/SKILLS/ABILITIES - Maintains relationships with Health Plans/Product Team and Corporate Operations to ensure all end-to-end business requirements have been documented and interpretation is agreed on and clear for solutioning. - Ability to meet aggressive timelines and balance multiple lines of business, states, and requirement areas. - Strong interpersonal and (oral and written) communication skills and ability to communicate with those in all positions of the company. - Ability to concisely synthesize large and complex requirements. - Ability to organize and maintain regulatory data including real-time policy changes. - Self-motivated and ability to take initiative, identify, communicate, and resolve potential problems. - Ability to work independently in a remote environment. - Ability to work with those in other time zones than your own. JOB QUALIFICATIONS Required Qualifications - At least 4 years of experience in previous roles in a managed care organization, health insurance or directly adjacent field, or equivalent combination of relevant education and experience along with Medical Billing and coding experience - Policy/government legislative review knowledge. - Strong analytical and problem-solving skills. - Robust knowledge of Office Product Suite including Word, Excel, Outlook and Teams. - Previous success in a dynamic and autonomous work environment. Preferred Qualifications - Project implementation experience - Knowledge and experience with federal regulatory policy resources including Centers for Medicare & Medicaid Services (CMS) and the Affordable Care Act (ACA). - Medical Coding certification. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

• Receive hands-on training and feedback on assigning codes to patient accounts • Gain experience to become an independent medical coder • Reviews work queue assignments and prioritizes by date, charges and payors • Assigns and sequences diagnosis and procedure codes using appropriate classification systems • Follows coding guidelines and billing requirements to ensure compliance • Verify charge entries are accurate based on the documentation provided • Identify and escalate any obstacles to fulfilling job responsibilities