Hospital Coding Specialist II

Orlando Health, Inc.; Orlando (FL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Student loan repayment

Tuition reimbursement

Free college education programs

Paid paternity leave

Job summary

Orlando Health, Inc. is seeking a skilled hospital coder to manage multifacility Same Day Surgery and Outpatient Observation coding across the system, ensuring compliance with state and federal regulations.

You will utilize ICD-10-CM and CPT-4 codes, EPIC EMR, encoder, CAC tools, and contribute to accurate APC assignments for reimbursement. This role requires knowledge of coding guidelines, medical necessity/CCI edits, and collaboration with physicians and revenue teams.

Qualifications

• Bachelor’s or Associate degree required or equivalent.
• Coding certificate program preferred.
• Computer literacy and medical terminology required.
• Demonstrated knowledge of coding complex outpatient procedures.
• Score 90% or higher on Orlando Health coding skills test.

Responsibilities

• Review clinical documentation and assign diagnoses/procedures to multifacility visits using ICD-10-CM/CPT-4.
• Sequence codes for APC assignment per guidelines and CMS rules.
• Collaborate with physicians, office staff, and care teams.
• Communicate effectively and maintain professional interactions.
• Ensure medical necessity coverage and accurate ICD-10-CM coding.

Skills

Hospital coding

Communication skills

Attention to detail

EPIC EMR experience

Education

Bachelor’s or Associate degree

Coding certificate program

Computer literacy

Medical terminology

Anatomy & physiology

Coding skills assessment 90%+

Tools

EPIC EMR

Encoder

CAC

NCCI edits

Job description

Position Summary

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

Orlando Health - Benefits & Perks

All Inclusive Benefits (start day one)

• Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

Forbes Recognizes Orlando Health as a Best-In-State Employer

• Forbes has named Orlando Health as one of America's Best-In-State Employers for 2024. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. \"We are proud to named once again as a best place to work,\" said Karen Frenier, VP (HR). \"This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.\"

Position Summary

Multifacility responsibility for complete and accurate coding of Same Day Surgery and Outpatient Observation for entire Orlando Health system's purposes of billing in compliance with State and Federal regulations.

Responsibilities

Essential Functions

• Perform review and analysis of clinical documentation and accurately assign diagnosis and procedure codes for multifacility Same Day Surgery and Outpatient Observation visits using ICD-10-CM and/or CPT-4 classification systems+, utilizing EPIC Electronic Medical Record (EMR), encoder, computer assisted coding (CAC), and other applications as applicable.
• Appropriately sequence diagnoses/status codes and HCPCS Level 1 and Level II CPT-4 procedure codes for proper Ambulatory Classification (APC) assignment, utilizing applicable coding conventions, Official Guidelines on Coding and Reporting, and Center for Medicare and Medicaid Services (CMS) guidelines.
• Communicates cooperatively and constructively with physicians, physicians’ office personnel, guests, patients, and members of the healthcare team.
• Demonstrates good verbal communication skills.
• Ensure procedure medical necessity coverage, when possible, by complete review of provider documentation and accurate ICD-10-CM code assignment.
• Accurately assign modifiers to CPT-4 procedures as applicable.
• Accurately clear all applicable NCCI edits and coding validation check errors/warnings at the time of coding.
• Accurately abstracts information into hospital information system.
• Request additional documentation, as needed, to ensure complete accurate code assignment.
• Query physicians for clarification of documentation discrepancies and inconsistencies.
• Effectively collaborate with other revenue management departments for resolution of account errors or anomalies.
• Works with coding teams to ensure completion of all coding within corporate goals.
• Provides data for reports on statistics, optimization, productivity, etc.
• Maintains 95% accuracy and participates in department QA studies.
• Maintains level of productivity established by department.
• Cross trains in all aspects in coding based on department need.
• Attends departmental and other meetings as requested.
• Completes and actively participates in education activities as assigned by OH Hospital Coding Leadership.
• Demonstrates knowledge and understanding of coding guidelines, procedures, medical necessity/CCI edits and the APC reimbursement system and keeps abreast of current coding changes and standards of care to maintain.
• Complies with the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), and adheres to official guidelines
• Assures confidentiality of patient information.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions

• Maintains established work production standards.
• Works as a team member to meet department goals.
• Assumes the responsibility for professional growth and development through education programs, research, etc.

Qualifications

Education/ Training

• Bachelor’s or Associates degree; OR
• o Coding certificate program and
• o Computer literacy required and
• o Medical terminology, anatomy and physiology required and
• o Demonstrated knowledge of coding complex outpatient surgical procedures and
• o Score 90% or better on Orlando Health level II coding skills test

Licensure/ Certification

• Must maintain one of the following:
• Certified Coding Specialist (CCS)
• Coding Associate (CCA) by the American Information Management Association (AHIMA) - renewed every 2 years
• Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) - renewed every 2 years.
• Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC) - renewed every 2 years.
• Registered Health Information Administrator (RHIA) - preferred but not required
• Registered Health Information Technician (RHIT) - preferred but not required

Experience

• 2 years previous hospital coding experience required.
• Thorough knowledge of coding classification systems required.