Physician Coding Ed Spec Sr - Orlando Health

Orlando Health Medical Group is a comprehensive physician group serving patients from across the southeastern United States. With more than 200 practices and 1,200 physicians, Orlando Health Medical Group has a strong representation in over 55 specialties, including cardiology, vascular medicine, orthopedics, oncology, digestive health, neurology, neurosurgery, bariatric surgery, general surgery, bone marrow transplant and critical care medicine, as well as more than 30 pediatric subspecialties, women’s health, primary care and the largest hospitalist program in Florida. Orlando Health Medical Group is part of the Orlando Health system of care, which includes award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities that span Florida’s east to west coasts and beyond. Collectively, our 27,000+ team members honor our over 100-year legacy by providing professional and compassionate care to the patients, families and communities we serve. 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’

The Physician Coding Education Specialist, Sr. is the principal position who works with Physician Education Specialists and the Physician Coding Auditors to monitor, organize, update and support professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers, along with analyzing physician coding trends and providing
instruction that will contribute to effective productivities. This position is a centralized team member that also acts as the primary concierge between the Coding team members and the respective department.

• Location: Hybrid Remote & On-site
• Status: Full Time (exempt)
• Days: Monday through Friday
• Shift: Day (flextime plan with the possibility of occasional early morning/evening hours)

• Active coordination with internal auditors, educators and denials team for analyzing professional coding for all assigned service lines and divisional coders.
o Supports Educators in identifying educational needs and growth
o Provides leadership support for education when needed and requested.
o Provides Department leadership the needed support in identifying and correcting coding errors.
o Provides practice guidance and providers the security that we are capturing the service accordingly.
o Ensures arrangement of additional education when needed and requested.
• Provides guidance and support to Coder I, Coder II and Coder Sr for any necessary education or audit explanation.
• Optimizes the flow of provider education across OHMG.
• Instrumental role in maximizing proper reimbursement, ensuring accurate billing, and maintaining compliance with regulatory requirements.
• Identifies and communicate physician documentation and coding opportunities for improvement.
• Takes the initiative to identify and solve complex trending coding issues affecting the physician revenue cycle and provide the
necessary feedback to correct claims on a go-forward basis as well as recovered underpaid amounts.
• Collaborates with coding department management to ensure appropriate and complete follow up of educational opportunities have been supplied.
• Provides occasional reporting to deliver accurate documentation of internal coding enhancements.
• Attends payor, departmental and interdepartmental meetings, as required.
• Utilizes resource material available in department, CMS, AMA, and AHCA to support coding practices.
• Oversees research, creation, and present mandatory education sessions for annual coding guidelines and quarterly updates.
• Utilizes the possible support of consultants with complex cases.
• Provides training to new onboarding team members, when necessary.
• Documents and presents findings and trends to Coding leadership.
• Reports any compliance and/or risk issues to the Coding leadership.
• Supports the development and implementation of coder enhancement strategies
o New CMS and payor released information
o Assists with basic internal coders auditing
• Provides daily support to all assigned practice managers on their coding related questions, when necessary.
• Monitors delinquent documentation as it pertains to education.
• Oversees physician reviews, as needed, and provides data/information to manager.
• Actively participates in departmental monthly provider and AR meetings.
• Serves as a subject matter expert in clinical documentation and coding best practices for both internal and external partners.
• Serves as a mentor to new team members, when necessary.
• Guides and educates coding team members by addressing errors, performance issues, and trends identified through reporting.
• Actively participates in prospective program development, execution, and performance.
• Takes an active role in overseeing the developing and presenting educational programs to physicians, physician extenders, and physician offices.

Effectively communicates best practice physician coding related feedback with physicians, non-physician providers, physician office staff, administration, practice managers, and team members.
• Takes an active role with Manager to support the developing and presenting educational programs to Physician & Professional Services team, physicians, physician extenders, physician offices, and all members of the coding team and manager.
• Assists in writing logic, requesting and implementing new warnings and errors in the Epic system.
• Maintains current knowledge of coding principles and guidelines as coding conventions are updated; monitors and analyzes current industry trends and issues for potential organizational impact
• Responds to coding questions from assigned coders/providers and provides official coding references and guidelines.
• Oversees the feedback on the application of coding guidelines, practices, and proper documentation techniques, and data quality improvements
• Maintains an/or supports an education calendar and with provider in-services, provider education sessions and weekly or monthly meetings.
• Addresses all Orlando Health departments professionally and positively, in all settings, by always maintaining a high level of professional demeanor and dress.
• Maintains patient and coder confidentiality results.
• 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.
• Follow and adhere to Standards of Ethical Coding, all applicable regulations and guidelines, and all client specific policies.
• Other duties as assigned based on company needs and projects.
• Provides additional onsite support for the physician coding education team. This position is a hybrid and does provide for onsite support of education, when requested.
Skills Knowledge
• Excellent knowledge of CPT, ICD-10 and HCPCS coding principles, governmental regulations, protocols, and third-party payer requirements pertaining to billing, coding and documentation.
• Proficiency in coding including ICD-10, CPT, E/M, HCPCS, and modifiers while maintaining a 90% accuracy.
• Ability to maintain 90% physician coding accuracy rate.
• Excellent knowledge of medical terminology.
• Preferred, experience working with EPIC Electronic Medical Records.
• Works independently under general supervision with strong organizational skills.
• Must be able to function as part of a team with a positive attitude using effective interpersonal skills
• Must possess excellent investigative, written and verbal skills, and have the ability to conduct educational needs to educate to a wide range of comprehension levels
• Proficiency in recognizing, identifying and capturing missed/potential/overlooked revenue opportunities.
• High level of communication with our third-party auditing partner.
• Ability to handle numerous projects and appropriately prioritize tasks to meet deadlines.

Education/Training
• Associate degree or five (5) years of directly related work experience may substitute for the associate degree.
• Possesses exceptional knowledge in Microsoft Office, Word and Outlook, with preferred knowledge of PowerPoint as well as moderate experience with Microsoft Excel and TEAMS.
• Thorough knowledge of official coding guidelines as per AMA, AHA, and CMS as evidenced by results of coding skills test of 90% or better.

Licensure/Certification
Must hold and maintain at least one (1) of the following national certifications:
• Certified Professional Coder (CPC) through the American Academy of Professional Coders

Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA)
• Certified Coding Specialist-Physician (CCS-P) through the American Health Information Management Association (AHIMA)
• Certified Medical Coder (CMC) through Practice Management Institute
• Certified Professional Medical Auditor (CPMA)

Experience
• Minimum of two (2) years experience as a Physician Coding Educator.
• 5-6 years of professional based coding experience is required.
• Professional based coding experience must include – Office, Inpatient, Bedside Procedures, Surgical Coding, Teaching & Physician extender provider coding, multiple specialties is desired.
• Level one (1) Trauma hospital experience is preferred.
• Experience with a large organization, multi-location, multi-specialty with high volume providers is preferred.