Hospital Coding Specialist II

Orlando Health•Orlando, FL

About The Position

The Hospital Coding Specialist II is responsible for multifacility coding of Same Day Surgery and Outpatient Observation visits across the Orlando Health system. The role reviews clinical documentation and assigns complete, accurate diagnosis and procedure codes to support billing in compliance with state and federal regulations. The position uses ICD-10-CM and CPT-4 classification systems, as well as EPIC, encoders, computer-assisted coding, and other applicable applications. The specialist supports appropriate APC assignment, medical necessity coverage, accurate code sequencing and modifiers, and resolution of coding edits and account errors. The role works with physicians, patients, healthcare teams, revenue management departments, and coding teams to clarify documentation and meet coding, productivity, accuracy, and department goals. The position also requires maintaining coding knowledge, confidentiality, professional development, and compliance with Orlando Health policies and ethical coding standards.

Requirements

Bachelor’s or associate degree, or completion of a coding certificate program.
Computer literacy.
Knowledge of medical terminology, anatomy, and physiology.
Demonstrated knowledge of coding complex outpatient surgical procedures.
Score 90% or better on the Orlando Health Level II coding skills test.
At least 2 years of previous hospital coding experience.
Thorough knowledge of coding classification systems.
Maintain one of the following credentials: Certified Coding Specialist (CCS); Coding Associate (CCA) from AHIMA; Certified Professional Coder (CPC) from AAPC; or Certified Outpatient Coder (COC) from AAPC.
CCA, CPC, and COC certifications must be renewed every 2 years.

Nice To Haves

Registered Health Information Administrator (RHIA) certification; preferred but not required.
Registered Health Information Technician (RHIT) certification; preferred but not required.

Responsibilities

Review and analyze clinical documentation and assign accurate diagnosis and procedure codes for multifacility Same Day Surgery and Outpatient Observation visits.
Sequence diagnoses and status codes and assign HCPCS Level I and Level II CPT-4 procedure codes to support proper Ambulatory Payment Classification (APC) assignment.
Apply coding conventions, Official Guidelines on Coding and Reporting, and CMS guidelines.
Communicate cooperatively and constructively with physicians, physicians’ office personnel, guests, patients, and healthcare team members.
Review provider documentation and assign accurate ICD-10-CM codes to support procedure medical necessity coverage when possible.
Assign applicable CPT-4 modifiers and clear applicable NCCI edits and coding validation errors or warnings.
Abstract information accurately into the hospital information system.
Request additional documentation and query physicians to clarify documentation discrepancies and inconsistencies.
Collaborate with revenue management departments to resolve account errors or anomalies.
Work with coding teams to complete coding within corporate goals.
Provide data for reports on statistics, optimization, and productivity.
Maintain 95% accuracy, participate in department quality assurance studies, and meet department productivity standards.
Cross-train in coding areas based on department needs.
Attend departmental and other meetings as requested and participate in assigned education activities.
Maintain knowledge of coding guidelines, procedures, medical necessity, CCI edits, APC reimbursement, current coding changes, and standards of care.
Comply with AHIMA and AAPC Standards of Ethical Coding and official coding guidelines.
Maintain patient confidentiality and comply with Orlando Health policies and procedures.
Maintain regular and punctual attendance consistent with applicable policies and laws.
Contribute as a team member to department goals and pursue professional growth through education programs, research, and other activities.