Clinical Coder I

Main Campus (Gainesville, FL)
Jan 13, 2021
Employment Type
Full Time
Institution Type
Four-Year Institution

Job no: 515460
Work type: Staff Full-Time
Location: Main Campus (Gainesville, FL)
Categories: Administrative/Professional, Health Profession
Department:29170000 - MD-ORTHOPAEDICS / REHAB

Advertised: 11 Jan 2021 Eastern Standard Time
Applications close: 18 Jan 2021 Eastern Standard Time

Classification Title:

Clinical Coder 1

Job Description:

Responsibilities include:

  • Reviews daily Evaluation and Management (E&M) charges pending in E&M workque. Responsible for resolving charge review edits related to registration, insurance and authorizations. Reconcile daily operating room (OR) schedule and cross-reference the charge in the surgical workque. Reviews surgical cases for missing documentation or errors regarding the operative notes or case attestation. Review missing charge report twice per week for any missing charges. Must review case in EPIC to determine if surgery case was actually completed or cancelled. Communicate to providers any charges not submitted. Reports any issues back to supervisor regarding billing and coding edits. Reviews codes assigned by physicians, or assign the appropriate, ICD-10, ICD-9 and CPT codes based on reports and/or progress notes provided by physicians. Assist providers with coding education and feedback to improve their accuracy in code selection
  • Ensure continuous quality improvement of physician coding and team billing practices. This includes review of and recommendations for ICD-10; ICD9/CPT coding to ensure compliance with policies for coding and claim submission.
  • Monitor that reimbursement levels are appropriate, especially in areas that are at risk for improper reimbursement. Analyze and propose opportunities in the managed care contracting process
  • Ensure clean claim submission by resolving system edits for inpatient and outpatient hospital services and doctor's office edits when applicable. Review and analyze rejections to determine trends; propose solutions for change in process as appropriate. Identify payer-specific trends and provide support to resolve claim issues.
  • Participate in group discussions and problem resolution activities pertaining to the division and department; proactively serve as a resource for providers for coding/compliance issues. Work collaboratively with providers, peers, payers and others.
  • Track and resolve provider enrollment issues for new providers. Work with others to ensure that billing numbers are received and A/R is released for timely payment.
  • Demonstrate a working knowledge of Managed Care processes. Stay abreast of annual coding updates.

Expected Salary:

$17.50-$19.50 per hour, commensurate with qualifications.

Minimum Requirements:

High school diploma or equivalent. Certified Professional Coder (CPC)/ American Academy of Professional Coders (AAPC) /Certified Coding Specialist (CCS-P)/Certified Outpatient Coder (CPC)/Certified Compliance Professional-Physician (CCP-P)/Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) must be obtained within 6 months of hire date.

Preferred Qualifications:

Preferred Qualifications include:

  • Prior experience working in a healthcare environment
  • Advanced knowledge of medical terminology
  • Professional coding certification
  • Demonstrate ease with learning new programs
  • Ability to multitask
  • Ability to prioritize work and proceed with minimal supervision
  • Ability to maintain a professional approach at all times and function in a team environment
  • Must be able to communicate effectively both verbally and in writing

Special Instructions to Applicants:

In order to be considered, you must upload your cover letter, 3 references and resume.

This requisition will be used to fill multiple positions.

Application must be submitted by 11:55 p.m. (ET) of the posting end date.

Health Assessment Required:


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