| Job Description: |
The Department of Medicine, Administration is seeking a full time Clinical Coder III. This position is responsible for coding and billing of professional medical fees for all billing providers in the Department of Medicine, Division of Nephrology. This involves extracting billable services from the patient charts and applying appropriate CPT and ICD-10 codes and then entering these services in the EPIC billing system for submission. This position works closely with Nephrology faculty, fellows and the Residents to provide education on correct coding, proper documentation to maximize physician reimbursement, and ensure compliance with federal and state regulations.
Essential Functions:
1. Reviews provider progress and procedure reports through EPIC for extraction of billable services for all patients (inpatients and observation short stays) for Nephrology which may include inpatient attending and consultation services.
2. Performs highly specialized coding abstraction for Evaluation and management services and dialysis procedures and acts as an expert in Nephrology.
3. Applies appropriate CPT and ICD-10 codes and confirms adequate teaching provider documentation.
3. Responsible for charge data entry into EPIC Resolute while ensuring clean claim submission to include working any edits that Charge Review may generate.
4. Resolves all denials by working closely with University of Florida Physicians (UFP) in order to maximize revenue and prevent errors. Assists other divisions in coding and billing as needed to ensure appropriate lag time is maintained.
1. Provides feedback to providers regarding accurate documentation, reimbursement maximization, and compliance.
2. Develops and maintains documentation standards for coding and creates training materials. Schedules and facilitates educational sessions with providers individually and/or in groups to communicate coding guidelines. Meets regularly with billing providers to address areas in need of improvement.
3. Reviews and validates that provider note templates are set up with compliant drop downs and selections.
1. Researches coding issues through all available resources, including but not limited to professional associations, federal and private payer guidelines, and coding networks.
2. Informs supervisors and faculty of important changes in coding and reimbursement.
3. Provides guidance to other coders by acting as a coding resource/expert when needed.
Miscellaneous Duties
1. Prioritizes work assignments based on urgency and deadlines.
2. Attends continuing education courses, seminars, conferences, and meetings in order to increase knowledge and maintain coding credential.
3. Works cooperatively with Departmental and Divisional billing staff to resolve backlog and provide back-up coverage of billing functions for vacations and illnesses of other billing staff members.
4. Serves as a liaison to multiple internal and external entities including, but not limited to:
• Department of Medicine
• Other Divisions within the Department of Medicine
• Hospitalist physicians
• University of Florida Physicians (UFP)
• Compliance Office
• Referring physicians, patients, and patients’ families
• Constantly strives to represent the Division, Department, and University in a positive, courteous, and professional manner.
• Other duties as assigned.
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