Clinical Coder III

1 week ago


Gainesville, Florida, United States InsideHigherEd Full time
Job Description

We are seeking a highly skilled Clinical Coder III to join our team in the Department of Neurosurgery. As a key member of our revenue cycle team, you will be responsible for performing highly specialized diagnosis and procedural coding for all operative procedures and inpatient consulting services performed by the faculty of the Department of Neurological Surgery.

Key Responsibilities:
  • Review operative reports and/or progress notes to determine documentation of billable services and to either verify or to apply the appropriate ICD-10 and CPT codes.
  • Confirm physician attestation statements are in place, when appropriate.
  • Provide guidance and education to attending surgeons, fellows and residents on all coding issues.
  • Research coding questions through all available resources, including professional associations, federal and private payer guidelines, and coding networks.
  • Meet with Department Chair or Administrator on a regular basis to review individual or product line coding issues.
  • Verify patient demographic and health insurance data for accuracy and resolve any discrepancies.
  • Ensure that there are no unsigned or missing operative records.
  • Enter 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.
  • Ensure proper documentation of teaching provider involvement.
  • Monitor and correct all TES edits in the Epic system.
  • Set up guarantor accounts in Epic by determining if charges are considered personal/family, auto, worker's comp, etc.
  • Add 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.
  • Verify patient insurance by electronic submission through Epic checking website or by contacting insurance company via telephone.
  • Determine if patient was an emergency admit, hospital to hospital transfer or an endovascular case for statistical database.
Collaboration and Communication:
  • Collaborate 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.
  • Assist the department leadership in generating processes to resolve unfavorable trends.
  • Work closely with Assistant Director to determine charges to be rendered for surgical procedures and insurance reimbursement on those patient accounts.
  • Attend monthly meetings with the Coder's Forum to review EPIC product line performance and coding issues.
Professional Development:
  • Attend periodic meetings, seminars and classes to improve coding skills.
  • Remain current on coding changes and work to become an expert in neurosurgical coding.
  • Review publications for same purpose.
Training and Support:
  • 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.
Liaison and Communication:
  • Serve as a liaison to multiple internal and external entities, including Department of Neurosurgery, University of Florida Physicians (UFP), and Compliance Office.


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