Nemours is seeking a Coding and Billing Specialist in Orlando, FL.
Assesses documentation for each service rendered in the hospital’s place of service in order to accurately code principal diagnoses, secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer-specific rules for commercial or Medicaid insurance, and drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping.
This role also includes working knowledge of revenue charge capture and its impact on hospital billing, including soft vs. hard coded charges, revenue codes, grouper function, financial impact, surgical charges such as supplies and implants, and pharmacy charges such as contrast and patient-supplied items.
The specialist will review concurrent and discharged accounts across multiple specialties, analyze high-risk encounters for missing charges, apply payer-specific coding and billing trends, support documentation queries, and work with hospital information systems to retrieve patient and order data.
Associate's degree required.
Medical Terminology.
Anatomy and Physiology.
One of the following certifications: CPC, CCS, RHIT, RHIA, or COC; CRC preferred.
3 to 5 years of experience.
Strong knowledge of ICD-10-CM, CPT-4, modifier application, ICD-10-CM coding guidelines, M.E.A.T. criteria, charge capture, revenue codes, and hospital information systems.
Location
Orlando, Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago