Corporate Coding Analyst
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<br>Position Summary<br><br><p style="margin: 0px;"><img src="https://orlandohealth.icims.com/icims2/servlet/icims2?module=AppInert&action=download&id=53860&hashed=311558797" alt="Orlando Health Logo"></p><p style="margin: 0px; text-align: center;"><span style="font-size: 10pt;"><span style="font-family: verdana, geneva;">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 </span><span style="font-family: verdana, geneva;">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 </span><span style="font-family: verdana, geneva;">coasts and beyond.</span></span></p><p style="margin: 0px;"> </p><p style="margin: 0in; font-family: Calibri; font-size: 11.0pt;"><span style="font-weight: bold; text-decoration: underline; font-family: verdana, geneva; font-size: 10pt;">ORLANDO HEALTH - BENEFITS & PERKS:</span></p><p style="margin: 0in; font-family: Calibri; font-size: 11.0pt;"><span style="font-weight: bold; font-family: verdana, geneva; font-size: 10pt;">All Inclusive Benefits (start day one)</span></p><ul style="direction: ltr; unicode-bidi: embed; margin-top: 0in; margin-bottom: 0in;" type="disc"><li style="margin-top: 0; margin-bottom: 0; vertical-align: middle;"><span style="font-family: verdana, geneva; font-size: 10pt;">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.</span></li></ul><p style="margin: 0in; font-family: Calibri; font-size: 11.0pt;"><span style="font-weight: bold; font-family: verdana, geneva; font-size: 10pt;">Forbes Recognizes Orlando Health as a Best-In-State Employer</span></p><ul style="direction: ltr; unicode-bidi: embed; margin-top: 0in; margin-bottom: 0in;" type="disc"><li style="margin-top: 0; margin-bottom: 0; vertical-align: middle;"><span style="font-family: verdana, geneva; font-size: 10pt;">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. <span style="font-style: italic;">"We are proud to be named once again as a best place to work,"</span> said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.</span></li></ul><p style="margin: 0in; font-family: Calibri; font-size: 11.0pt;"><span style="font-weight: bold; font-family: verdana, geneva; font-size: 10pt;">Employee-centric</span></p><ul style="direction: ltr; unicode-bidi: embed; margin-top: 0in; margin-bottom: 0in;" type="disc"><li style="margin-top: 0; margin-bottom: 0; vertical-align: middle;"><span style="font-family: verdana, geneva; font-size: 10pt;">Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare</span></li></ul><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="text-decoration: underline;"><strong><span style="font-family: verdana, geneva; font-size: 10pt;">Position Summary:</span></strong></span></p><p style="margin: 0px;"><span style="font-size: 10pt;">Reviews, analyzes, and resolves accounts that have failed coding and charge related edits, including medical necessity, National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), and other exceptions requiring clinical/coding expertise. </span></p> <br>Responsibilities<br><br><p style="margin: 0px;"><span style="text-decoration: underline; font-size: 10pt;"><strong>Essential Functions:</strong></span><br><span style="font-size: 10pt;">• Extracts statistical data, performs Root Cause Analysis to generates supporting trends reports, and notifies Clinical Liaisons and </span><span style="font-size: 10pt;">Manager(s) of any trends identified.</span><br><span style="font-size: 10pt;">• Works assigned Epic work queues specializing in assessment and correction of Correct Coding Initiative (CCI) and Medical </span><span style="font-size: 10pt;">Necessity (MN) Edits and post bill denials relating to the same.</span><br><span style="font-size: 10pt;">• Manages and prioritizes tasks to meet deadlines for any projects and audits assigned.</span><br><span style="font-size: 10pt;">• Performs documentation reviews of CCI and MN to necessitate clean claims and denial reconciliation.</span><br><span style="font-size: 10pt;">• Provides ad-hoc multivariate reports to management.</span><br><span style="font-size: 10pt;">• Works closely with the Revenue Integrity Clinical Liaisons to assure reconciliation of edits to meet department and organization </span><span style="font-size: 10pt;">goals.</span><br><span style="font-size: 10pt;">• Able to locate and interpret local coverage determination (LCD) from our MAC (First Coast) and national coverage determination </span><span style="font-size: 10pt;">(NCD) from CMS.</span><br><span style="font-size: 10pt;">• Assists with the training of new Revenue Integrity team members. </span><br><span style="font-size: 10pt;">• Interacts independently to coordinate edit resolution workflow.</span><br><span style="font-size: 10pt;">• Demonstrates exemplary customer service and critical thinking skills to include problem resolution and process improvement </span><span style="font-size: 10pt;">skills. </span><br><span style="font-size: 10pt;">• Communicates cooperatively and constructively with multi-disciplinary teams.</span><br><span style="font-size: 10pt;">• Demonstrates professional verbal and written communication skills. </span><br><span style="font-size: 10pt;">• Provides statistical reports to management as requested. </span><br><span style="font-size: 10pt;">• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, </span><span style="font-size: 10pt;">state, and local standards. </span><br><span style="font-size: 10pt;">• Maintains compliance with all Orlando Health policies and procedures.</span></p><p style="margin: 0px;"><br><span style="text-decoration: underline; font-size: 10pt;"><strong>Other Related Functions:</strong></span><br><span style="font-size: 10pt;">• Maintains established work production standards. </span><br><span style="font-size: 10pt;">• Works as a team member in facilitating efficient and effective problem solving to meet goals.</span><br><span style="font-size: 10pt;">• Assumes responsibility for professional growth and development.</span><br><span style="font-size: 10pt;">• Attends department meetings as required.</span></p> <br>Qualifications<br><br><p style="margin: 0px;"><span style="text-decoration: underline; font-size: 10pt;"><strong>Education/Training:</strong></span><br><span style="font-size: 10pt;">• Associates degree in business, healthcare, or related field required. Four (4) years of directly related work experience may substitute for the Associates degree (in addition to requirements listed in the Experience section). </span><br><span style="font-size: 10pt;">• Medical terminology required. </span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="text-decoration: underline; font-size: 10pt;"><strong>Licensure/Certification:</strong></span><br><span style="font-size: 10pt;">• Current coding certification (e.g., RHIA, RHIT, CPC, CCS) from AAPC or AHIMA required at the time of hire or must obtain within 6 months of hire.</span></p><p style="margin: 0px;"> </p><p style="margin: 0px;"><span style="font-size: 10pt;"><span style="text-decoration: underline;"><strong>Experience:</strong></span><br>• Two (2) years of Revenue Cycle experience. Extensive PC and Excel experience is required. EPIC Experience a plus. <br>• Expertise in health records review and abstracting of required data to satisfy CCI and MN edits.<br>• Exceptional understanding of electronic medical records (EMR) and charge management.<br>• Extensive knowledge of ICD-10-CM, CPT, HCPCS, and modifiers.</span></p>