Clinical Coder II-Department of Neurosurgery

University of Florida•Gainesville, FL

6d•$25 - $28

About The Position

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. This involves reviewing operative reports and/or progress notes to determine documentation of billable services and to apply the appropriate ICD-10 and CPT codes. The role also confirms physician attestation statements when appropriate, provides guidance and education to attending surgeons, fellows, and residents on coding issues, and researches coding questions through various resources. The position involves verifying patient demographic and health insurance data, maintaining a database of coding information, ensuring no unsigned or missing operative records, and entering charges for surgical cases and non-surgical inpatient events. Chart reviews are conducted for regulatory and coding compliance, and proper documentation of teaching provider involvement is ensured. This role monitors and corrects TES edits in the Epic system, sets up guarantor accounts, adds insurance information, and fills out claim information records. Patient insurance is verified electronically or via telephone. The position also determines if a patient was an emergency admit, hospital to hospital transfer, or an endovascular case for statistical purposes. The Clinical Coder II works closely with the Associate Director to determine charges and insurance reimbursement, attends meetings to review EPIC product line performance and coding issues, and conducts independent research for reports. The role requires attending periodic meetings, seminars, and classes to improve coding skills, and collaborating with leadership to develop processes that positively impact the department. Staying current on coding changes, especially in neurosurgical coding, is crucial, as is training faculty and residents on coding and billing methods and assisting them with coding questions and problems.

Requirements

High school diploma or equivalent
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)/ American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required

Nice To Haves

Knowledge of medical terminology
Knowledge of surgical coding
Certification as a coder, either CPC (American Academy of Professional Coders) or CCS-P (American Health Information Management Association)
Knowledge of business and office practice
Knowledge of Excel, and other applicable software
Ability to analyze financial data and able to generate understandable reports
Ability to communicate effectively, verbally and in writing

Responsibilities

Performs specialized diagnosis and procedural coding entry for review by the Clinical Coder IV for all operative procedures and inpatient consulting services.
Reviews operative reports and/or progress notes to determine documentation of billable services and to 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 issues through all available resources including 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 that there are no unsigned or missing operative records.
Enters charges for both surgical cases and non-surgical inpatient events.
Conducts chart reviews for the purpose of regulatory and coding compliance and 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 by determining the patient's relationship to the subscriber, obtaining insurance policy numbers and claim address and subscriber information.
Fills out claim information record for every charge submitted in Epic.
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.
Works closely with Associate Director to determine charges to be rendered for surgical procedures and insurance reimbursement on those patient accounts.
Attends monthly meetings with the Coder’s Forum to review EPIC product line performance and coding issues.
Conducts independent research and prepares reports as requested by Associate Director and faculty members to determine appropriateness and effectiveness of coding practices.
Attends periodic meetings, seminars and classes to improve coding skills.
Collaborates with the leadership of the department in developing processes to positively impact the department.
Remains current on coding changes and works to become an expert in neurosurgical coding.
Reviews publications for the purpose of staying current on coding changes.
Trains faculty members and residents on methods of coding and billing and keeps them apprised of coding changes.
Assists faculty with the resolution of coding questions and problems.