As one of the nation’s leading pediatric health care systems, Nemours is committed to providing all children with their best chance to grow up healthy. We offer integrated, family-centered care to more than 300,000 children each year in our pediatric hospitals, specialty clinics and primary care practices in Delaware, Florida, Maryland, New Jersey and Pennsylvania. Nemours strives to ensure a healthier tomorrow for all children – even those who may never enter our doors – through our world-changing research, education and advocacy efforts. At Nemours, our Associates help us deliver on the promise we make to every family we have the privilege of serving: to treat their child as if they were our own.
Nemours is seeking a Coder (Ambulatory), FULL-TIME, to join our Nemours Children's Hospital team in Orlando, Florida.
Located in Orlando, Fla., Nemours Children’s Hospital is the newest addition to the Nemours integrated healthcare system. Our 100-bed pediatric hospital also features the area’s only 24-hour Emergency Department designed just for kids as well as outpatient pediatric clinics including several specialties previously unavailable in the region. A hospital designed by families for families, Nemours Children’s Hospital blends the healing power of nature with the latest in healthcare innovation to deliver world-class care to the children of Central Florida and beyond. In keeping with our goal of bringing Nemours care into the communities we serve, we also provide specialty outpatient care in several clinics located throughout the region.
Responsible for coding physician practice claims for all assigned areas (i.e. professional fee abstracting (PFA) for critical care areas or department assigned (i.e. anesthesia, cardiology, orthopedics, etc)Each code assigned, both diagnosis (ICD 10 CM) or procedure (CPT 4) is accurate and supported by provider documentation.(Coders are required to have clinical rudimentary knowledge of multiple specialties.)
Ability to comprehend medical record documentation to accurately assign codes for each active session, in multiple specialties.
Codes a minimum of 80-100 sessions per shift accurately. (PFA volume varies on number of lines per session, therefore these sessions are done daily to minimize the increased line count.)
Evaluates accounts flagged for medical necessity inquiries, and provides needed information.
Works collaboratively in a team setting with providers, allied health staff, business office staff throughout the enterprise to achieve accurately coded 1500 claims.
Analyzes high-risk encounters for accurate charge capture and makes recommendation before transferring to second level review work queues.
Teaches, coaches and mentors all clinical charge capture staff to work collaboratively, accurately and decisively in session specific discussions.
Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with un-clear, or un-substantiated care rendered.
Coding knowledge of ICD 10 CM, CPT 4, and professional modifier application is critical and all associates are expected to maintain certification.
Cross over coding is expected to help others (as assigned) using written reliable methods which identifies standard work requirements by session type.
Associate's Degree required.
Minimum of six (6) months to one (1) year coding experience required.
CCS-P or CPC, RHIT or RHIA required.
Knowledge of all state and federal regulatory requirements associated with billing and coding.
Our dedication to professionals who are dedicated to children frequently earns Nemours a spot on the list of top workplaces in the communities we serve. Our Associates enjoy comprehensive benefits, including our unique “Bridge to a Healthy Future” pediatric health plan, an integrated wellness program, opportunities for professional growth, and much more. As an equal opportunity employer, Nemours focuses on the best-qualified applicants for our openings.
Nemours is a pediatric health system of hospitals and specialty clinics serving children and families throughout the Delaware Valley and Florida. Our dedicated professionals integrate medical care, research, health education, and prevention to help improve the lives of children every day.