Clinical Coder II-Department of Neurosurgery

Classification Minimum Requirements: High school diploma or equivalent and three years of professional medical coding experience. Appropriate college coursework or vocational/technical training may substitute at an equivalent rate for the required experience.

Responsibilities

• Performs specialized diagnosis and procedural coding entry for review by the Clinical Coder IV 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.
• Reviews operative reports and/or progress notes to determine documentation of billable services and to either verify or apply the appropriate ICD-10 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.
• Researches coding questions through 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.
• Maintains a database containing information including surgical charges, diagnosis codes, CPT codes, date of service, and attending physician.
• Ensures there are no unsigned or missing operative records.
• Enters charges for both surgical cases and non-surgical inpatient events.
• Conducts chart reviews for regulatory and coding compliance to ensure all services appropriate for coding and charging have been captured.
• Ensures proper documentation of teaching provider involvement.
• Monitors and corrects 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, including patient relationship to the subscriber, policy numbers, claim address, and subscriber details such as date of birth and address.
• Fills out claim information records in Epic for every charge submitted, including details such as date of injury, state of injury, type of injury, admit date, discharge date, and authorization number.
• Verifies patient insurance by electronic submission through Epic or by contacting the insurance company via telephone.
• Determines if patient was an emergency admit, hospital-to-hospital transfer, or an endovascular case for statistical database purposes.
• Works closely with Associate Director to determine charges to be rendered for surgical procedures and insurance reimbursement on patient accounts.
• Attends monthly Coder’s Forum meetings to review EPIC product line performance and coding issues.
• Conducts independent research and prepares reports as requested by Associate Director and faculty members to assess coding practices.
• Attends periodic meetings, seminars, and classes to improve coding skills.
• Collaborates with department leadership to develop processes that positively impact revenue cycle management.
• Remains current on coding changes and works to become an expert in neurosurgical coding.
• Reviews publications to stay updated on coding and rule changes that affect department reimbursement.
• Trains faculty members and residents on coding and billing methods and keeps them informed of coding changes.
• Assists faculty with the resolution of coding questions and problems.

Requirements

• High school diploma or equivalent and three years of professional medical coding experience. Appropriate college coursework or vocational/technical training may substitute at an equivalent rate for the required experience.
• Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) through the American Health Information Management Association (AHIMA) required.

Preferred Qualifications

• Knowledge of medical terminology and surgical coding.
• Knowledge of business and office practices.
• Proficiency in Excel and other applicable software.
• Ability to analyze financial data and generate understandable reports.
• Strong verbal and written communication skills.

Pay

$24.50-$27.50 per hour