Join our team as a Facility ED Coder! You will assess documentation for each hospital service to accurately code diagnoses, secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, CPT guidelines, and payer-specific rules for commercial and Medicaid insurance. This role requires strong knowledge of revenue charge capture and its impact on hospital billing, including assessment of surgical and pharmacy charges.

Responsibilities:

Comprehend medical record documentation to assign codes accurately for both concurrent and discharged accounts across multiple specialties.
Meet minimum requirements for production and quality monthly.
Apply code sequencing knowledge for grouper-related payers with attention to detail to avoid rework.
Understand and apply M.E.A.T. criteria using ICD-10-CM data set to capture diagnoses.
Analyze high-risk encounters for missing charges prior to encounter completion.
Incorporate payer-specific billing requirements and trends to reduce denials.
Maintain excellent coding knowledge of ICD-10-CM, CPT-4, and modifier application; maintain certification (CCS, CPC, RHIT, or RHIA).
Facilitate modifications to clinical documentation through query interaction to ensure captured information supports the level of service rendered, including chronic conditions, HCC, and RAF.
Utilize hospital information systems to retrieve data within complex filing schemas.

Qualifications:

Minimum Associate's degree.
Knowledge of Medical Terminology, Anatomy, and Physiology.
Current certification: CPC, CCS, RHIT, RHIA, or COC.

This is a remote position available to applicants residing in select states including Florida.

Nemours Children's Health is a pediatric health system dedicated to improving children's health through clinical care, research, education, advocacy, and prevention, serving over 1.7 million patient encounters yearly.