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Orlando Health logo
Orlando Health

Orlando Health is a nonprofit healthcare provider with a network of facilities throughout Orlando, Florida. The provider’s network of facilities consists of specialty hospitals f

Corporate Coding Analyst

Location

United States

Posted

16 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Corporate Coding Analyst

Orlando Health

Role Description Reviews, analyzes, and resolves accounts that have failed coding and charge related edits, including medical necessity, National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), and other exceptions requiring clinical/coding expertise. Responsibilities - Extracts statistical data, performs Root Cause Analysis to generate supporting trends reports, and notifies Clinical Liaisons and Manager(s) of any trends identified. - Works assigned Epic work queues specializing in assessment and correction of Correct Coding Initiative (CCI) and Medical Necessity (MN) Edits and post bill denials relating to the same. - Manages and prioritizes tasks to meet deadlines for any projects and audits assigned. - Performs documentation reviews of CCI and MN to necessitate clean claims and denial reconciliation. - Provides ad-hoc multivariate reports to management. - Works closely with the Revenue Integrity Clinical Liaisons to assure reconciliation of edits to meet department and organization goals. - Able to locate and interpret local coverage determination (LCD) from our MAC (First Coast) and national coverage determination (NCD) from CMS. - Assists with the training of new Revenue Integrity team members. - Interacts independently to coordinate edit resolution workflow. - Demonstrates exemplary customer service and critical thinking skills to include problem resolution and process improvement skills. - Communicates cooperatively and constructively with multi-disciplinary teams. - Demonstrates professional verbal and written communication skills. - Provides statistical reports to management as requested. - 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 in facilitating efficient and effective problem solving to meet goals. - Assumes responsibility for professional growth and development. - Attends department meetings as required. Qualifications - Associates degree in business, healthcare, or related field required. Four (4) years of directly related work experience may substitute for the Associates degree (in addition to requirements listed in the Experience section). - Medical terminology required. Requirements - Current coding certification (e.g., RHIA, RHIT, CPC, CCS) from AAPC or AHIMA required at the time of hire or must obtain within 6 months of hire. - Two (2) years of Revenue Cycle experience. Extensive PC and Excel experience is required. EPIC Experience a plus. - Expertise in health records review and abstracting of required data to satisfy CCI and MN edits. - Exceptional understanding of electronic medical records (EMR) and charge management. - Extensive knowledge of ICD-10-CM, CPT, HCPCS, and modifiers. Benefits - All Inclusive Benefits (start day one) - Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

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