Corporate Coding Analyst

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our 27,000+ team members serve communities that span Florida’s east to west coasts and beyond.

ORLANDO HEALTH - BENEFITS & PERKS:

All Inclusive Benefits (start day one)

• Student loan repayment, tuition reimbursement, FREE college education programs, retirement savings, paid paternity leave, fertility benefits, back up elder and childcare, pet insurance, PTO/Holidays, and more for full time and part time employees.

Forbes Recognizes Orlando Health as a Best-In-State Employer

• Forbes has named Orlando Health as one of America's Best-In-State Employers for 2024. Orlando Health is the top healthcare organization in the Metro Orlando area to make the prestigious list. "We are proud to be named once again as a best place to work," said Karen Frenier, VP (HR). "This achievement reflects our positive culture and efforts to ensure that all team members feel respected, supported and valued.

Employee-centric

• Orlando Health has been selected as one of the “Best Places to Work in Healthcare” by Modern Healthcare

Position Summary:

Reviews, analyzes, and resolves accounts that have failed coding and charge related edits, including medical necessity, National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE), and other exceptions requiring clinical/coding expertise.

Essential Functions:
• Extracts statistical data, performs Root Cause Analysis to generates supporting trends reports, and notifies Clinical Liaisons and Manager(s) of any trends identified.
• Works assigned Epic work queues specializing in assessment and correction of Correct Coding Initiative (CCI) and Medical Necessity (MN) Edits and post bill denials relating to the same.
• Manages and prioritizes tasks to meet deadlines for any projects and audits assigned.
• Performs documentation reviews of CCI and MN to necessitate clean claims and denial reconciliation.
• Provides ad-hoc multivariate reports to management.
• Works closely with the Revenue Integrity Clinical Liaisons to assure reconciliation of edits to meet department and organization goals.
• Able to locate and interpret local coverage determination (LCD) from our MAC (First Coast) and national coverage determination (NCD) from CMS.
• Assists with the training of new Revenue Integrity team members.
• Interacts independently to coordinate edit resolution workflow.
• Demonstrates exemplary customer service and critical thinking skills to include problem resolution and process improvement skills.
• Communicates cooperatively and constructively with multi-disciplinary teams.
• Demonstrates professional verbal and written communication skills.
• Provides statistical reports to management as requested.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions:
• Maintains established work production standards.
• Works as a team member in facilitating efficient and effective problem solving to meet goals.
• Assumes responsibility for professional growth and development.
• Attends department meetings as required.

Education/Training:
• Associates degree in business, healthcare, or related field required. Four (4) years of directly related work experience may substitute for the Associates degree (in addition to requirements listed in the Experience section).
• Medical terminology required.

Licensure/Certification:
• Current coding certification (e.g., RHIA, RHIT, CPC, CCS) from AAPC or AHIMA required at the time of hire or must obtain within 6 months of hire.

Experience:
• Two (2) years of Revenue Cycle experience. Extensive PC and Excel experience is required. EPIC Experience a plus.
• Expertise in health records review and abstracting of required data to satisfy CCI and MN edits.
• Exceptional understanding of electronic medical records (EMR) and charge management.
• Extensive knowledge of ICD-10-CM, CPT, HCPCS, and modifiers.