Certified professional coder Jobs in Gainesville, FL

Job Description :

The Department of Neurosurgery is seeking an experienced surgical coder to perform highly specialized diagnosis and procedural coding for all operative procedures and inpatient consulting services performed by the faculty of the Department of Neurological Surgery including those performed in Gainesville and at Halifax Regional Medical Center.

The ideal candidate will have a thorough knowledge of anatomy, surgical and medical terminology coding, a working knowledge of the billing requirements of insurance carriers, and the operating procedures of the department and the hospital(s).

The Lillian S. Wells Department of Neurosurgery at the University of Florida, College of Medicine is committed to providing comprehensive clinical services for the diagnosis, management, treatment, and rehabilitation of patients suffering from diseases of the brain, spinal cord, and nervous system, including brain tumors, aneurysms, stroke, epilepsy, functional disorders, and spinal disorders and injuries. Our clinical care mission also extends throughout North Central Florida through regional neurosurgery programs. We offer the full spectrum of neurosurgical and neuro-oncology treatment options for both adults and pediatric patients. Our research labs and investigator-led initiatives and clinical trials are developing promising new treatments for neurological diseases that are extremely difficult to treat with conventional therapies. The Department of Neurosurgery offers education and training programs such as ACGME-accredited neurosurgery residency programs and fellowship programs.

More About This Role

Performs highly specialized diagnosis and procedural coding for all operative procedures and inpatient consulting services performed by the faculty of the Department of Neurological Surgery including those performed in Gainesville and Halifax Regional Medical Center. Requires review of operative reports and / or progress notes to determine documentation of billable services and to either verify or to apply the appropriate ICD- and CPT codes. Confirms physician attestation statements are in place, when appropriate.

Provides guidance and education to attending surgeons, fellows and residents on all coding issues. As coding questions arise, incumbent is responsible for researching issues through all available resources including but not limited to professional associations, federal and private payer guidelines, and coding networks.

Meets with Department Chair or Administrator on a regular basis to review individual or product line coding issues.

Verifies patient demographic and health insurance data for accuracy and resolves any discrepancies.

Responsible for ensuring that there are no unsigned or missing operative records. Enters charges for both surgical cases and non-surgical inpatient events.

Responsible for chart reviews for the purpose of regulatory and coding compliance and to ensure all services appropriate for coding and charging have been captured. Ensures proper documentation of teaching provider involvement.

Responsible for monitoring and correcting all TES edits in the Epic system. Sets up guarantor accounts in Epic by determining if charges are considered personal / family, auto, worker’s comp, etc. Adds insurance information into Epic by determining what the relationship of the patient is to the subscriber, obtaining insurance policy numbers and claim address and subscriber information such as date of birth, address, etc. Fills out claim information record for every charge submitted in Epic, by adding items such as date of injury, state of injury, type of injury, admit date, discharge date, authorization number, etc. Verifies patient insurance by electronic submission through Epic checking website or by contacting insurance company via telephone. Determines if patient was an emergency admit, hospital to hospital transfer or an endovascular case for statistical database.

Collaborates with the leadership of the department in developing processes to positively impact the revenue cycle and insurance collections. Responsible for monitoring and analyzing denial and write-off trends. Once unfavorable reimbursement and billing trends are identified, the incumbent is responsible for assisting the department leadership in generating processes to resolve unfavorable trends.

Works closely with Assistant Director to determine charges to be rendered for surgical procedures and insurance reimbursement on those patient accounts. Attends monthly meetings with the Coder’s Forum to review EPIC product line performance and coding issues. Conducts independent research and prepares reports as requested by Associate Director and faculty members to determine appropriateness and effectiveness of coding practices.

Attends periodic meetings, seminars and classes to improve coding skills. Remains current on coding changes and works to become an expert in neurosurgical coding. Reviews publications for same purpose.

Train faculty members and residents on methods of coding and billing and keep them apprised of coding changes, as well as assists faculty with the resolution of coding questions and problems.

Serves as a liaison to multiple internal and external entities including, but not limited to : Department of Neurosurgery, University of Florida Physicians (UFP), and the UF Compliance Office.

Expected Salary :

Minimum Requirements :

High school diploma or equivalent and five years of experience in professional medical coding, with experience in two or three clinical specialties. Appropriate college coursework or vocational / technical training may substitute at an equivalent rate for the required experience. Certified Professional Coder (CPC) / American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required.

Preferred Qualifications :

• Knowledge of medical terminology, surgical coding.
• Knowledge of business and office practice.
• Knowledge of Excel, and other applicable software.
• Ability to analyze financial data and able to generate understandable reports.
• Ability to communicate effectively, verbally and in writing.