Reviews charges entered by a specific provider and verify the accuracy of the CPT, HCPCS and ICD-9/ICD-10 codes assuring correlation between diagnoses and procedures.
Edits the charges, if necessary; and selects appropriate physician as the billing provider for all charges billed.
Reviews the medical record, as necessary, to accurately process the claim. Assigns ICD-9/ICD-10 diagnosis codes and CPT/HCPS codes and modifiers as necessary to ensure accurate and complete coding as well as resolve any edits on account.
Verifies that all claim encounters received are appropriate and complete, ensuring age and gender edits are satisfied on all codes received from physician office. Ensures all edit issues and charge code discrepancies are resolved before billing.
Communicates with physicians and staff regarding coding questions or concerns. Educates physicians and staff concerning annual coding changes.
What Will You Need:
EDUCATION AND EXPERIENCE REQUIRED:
Minimum three (3) years of experience in a physician practice or medical billing or insurance carrier office
Experience with CPT, HCPS, ICD-9/ICD-10 coding rules, guidelines and functions
Experience in all lines of business; HMO, PPO, Medicare, Medicaid, etc.
EDUCATION AND EXPERIENCE PREFERRED:
Successful completion of a coding education program
Prior experience with Epic, OTTR and/or Sunport
High School graduate or GED
LICENSURE, CERTIFICATION, OR REGISTRATION PREFERRED:
Certified Physician Coding (CPC) or Certified Coding Specialist-Physician (CCS-P)
The Coder for the Ancillary Financial Services department is responsible for coding medical diagnoses and procedures using ICD-9/ICD-10 and CPT/HCPS and entering charges for related claims. Follows established charge entry guidelines and established regulatory billing guidelines. The Coder is the primary practice and billing office resource for coding questions and issues that may include research from outside agencies (e.g., ACOS, AMA, AAPC, and AHIMA). The Coder also is responsible for educating physicians and staff of changes involving CPT/HCPS and ICD-9/ICD-10 annual coding changes. Adheres to AdventHealth Corporate Compliance Plan and to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
AdventHealth Greater Orlando (formerly Florida Hospital) is one of the largest faith-based health care providers in the United States. For 150 years, we have carried on a tradition of providing whole-person care that not only addresses patients' physical ailments, but also supports their emotional and spiritual well-being. We demonstrate the same level of compassion and care for our employees as well, doing all that we can to help them realize their full potential – both personally and professionally.