Department: Revenue Integrity    

Status: Full Time

Shift: Hybrid (90% remote)

Location: Orlando FL

Title: Corporate Coding Analyst

Position Summary:

The corporate coding analyst 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.

Forbes has named Orlando Health as one of America's Best-In-State Employers. Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions.

“Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you.”

Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for and authentically serve our patients and families who make up the collective populations in our community. So, no matter who you are, what you believe or how you express yourself, you are welcome here.

ORLANDO HEALTH - BENEFITS & PERKS:

Competitive Pay

• Evening, nights, and weekend shift differentials offered for qualifying positions.

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 2021. 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.

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.