Coding Specialist II

Nemours in; Pensacola (FL); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player is seeking a dedicated Coding Specialist II to enhance their finance team. This role involves accurately coding diagnoses and procedures using CPT, ICD-10, and HCPCS codes while ensuring seamless charge capture and submission. You'll be pivotal in maintaining compliance with current coding requirements and providing exceptional customer service that aligns with the organization's mission and values. If you are passionate about coding and looking to make a meaningful impact in a supportive environment, this opportunity is perfect for you.

Qualifications

• 3-5 years of coding experience with CPT, ICD-10, and HCPCS.
• Must maintain annual continuing education for certification.

Responsibilities

• Code diagnosis and procedure codes accurately for admissions and procedures.
• Review and prepare charges for submission in Epic EMR.

Skills

CPT Coding

ICD-10 Coding

HCPCS Coding

Charge Capture

Customer Service

Education

High School Diploma

CPC Certification

CCS-P Certification

Tools

Epic EMR

Professional Billing System

Job description

Coding Specialist II (Finance)

Nemours is seeking a Coding Specialist II to join our team.

Primary Functions

1. Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-10, and HCPCS codes.
2. Review charges in Epic EMR and prepare charges for submission, including complete information regarding diagnosis, service/procedure codes, and any additional information needed for reimbursement.
3. Manually enter charges from partner hospitals as needed.
4. Ensure charge capture by reviewing census and/or O.R. schedule(s) daily.
5. Act as a coding resource to assigned divisions.

Essential Functions

1. Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-10, and HCPCS codes.
2. Prepare charges for data entry, including complete information regarding diagnosis, service/procedure codes, and any additional information needed for reimbursement.
3. Ensure charge capture by reviewing census and O.R. schedule(s) daily.
4. Act as a coding resource to assigned divisions.
5. Keep abreast of all current CMS and insurance plan coding requirements.
6. Register off-site inpatient and outpatient demographics as needed by accurately entering patient demographic, guarantor, and coverage information into EPIC.
7. Enter charges into the Professional Billing system following workflow and standard business practices for reconciliation.
8. Configure and run Charge Entry reports daily.
9. Be proficient in Professional Billing applications.
10. Follow data entry ground rules and standard business practices, and know where to locate relevant documentation.
11. Collaborate with the DAG team to obtain necessary coverages and authorizations.
12. Provide excellent customer service that promotes satisfaction among patients, staff, and customers, reflecting Nemours' mission, vision, and values.
13. Utilize Nemours Intranet and Managed Care Manual effectively.
14. Stay updated on insurance and system changes/updates.
15. Maintain strict confidentiality.
16. Support and assist other Coding Specialists as needed.
17. Maintain annual and new hire training requirements.
18. Perform other duties as assigned by leadership.

Qualifications

• High School Diploma
• CPC and/or CCS-P certification required
• 3-5 years of experience; must meet annual continuing education requirements to maintain certification.