Clinical Coder III

Summary

Code and bill professional medical fees for practicing clinical faculty physicians (College of Medicine). Schedule and facilitate education sessions to providers regarding documentation, reimbursement, and compliance. Develop and maintain documentation standards for coding and documentation training for the providers. Extract billable services from the patient charts, apply appropriate Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) codes and enter these services in the EPIC billing system for submission. Work closely with faculty, fellows and the Residents in the respective Divisions to provide education on correct coding, proper documentation to maximize physician reimbursement, and ensure compliance with federal and state regulations.

Examples of Work

Job functions are specific duties that would be included in the essential functions of the job description. These functions are not all-inclusive nor do they cover the full extent of the duties performed.

• Reviews provider progress and procedure reports through the electronic medical record system for extraction of billable services for all patients (inpatients and observation short stays) for assigned division which may include inpatient attending services and consultation services.
• Performs highly specialized Evaluation and Management coding abstraction and acts as an expert in assigned division within the department.
• Applies appropriate CPT and ICD-10 codes and confirms adequate teaching provider documentation such as attestations and time-based statements.
• Responsible for charge data entry into electronic medical record system while ensuring clean claim submission to include working any edits that may generate and appear in the work queue.
• Responsible for responding to the University of Florida Physicians’ billing group on information requests submitted through the follow-up work queue on all coding denials related to assigned specialty.
• Works closely with University of Florida Physicians (UFP) to research problems and maximizing revenues and preventing errors.
• Researches coding issues through all available resources, including but not limited to professional associations, federal and private payer guidelines, and coding networks.
• Inform Coordinators and faculty of important changes in coding and reimbursement.
• Schedules and facilitates education sessions to providers in regards to documentation, reimbursement, and compliance.
• Develops and maintains documentation standards for coding and documentation training to communicate to the providers individually and/or in groups.
• Provides feedback to provider regarding billing and coding and works with provider to resolve these issues to ensure accurate coding.
• Attend continuing education courses, seminars, conferences, and meetings.

Education and Experience

High school diploma or equivalent and five years of experience in professional medical coding, with experience in two or three clinical specialties. Appropriate college coursework or vocational/technical training may substitute at an equivalent rate for the required experience.

Licensure and Certification

Certified Professional Coder (CPC)/ American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS-P) required.

Supervision

None

To see common career pathways for each position at the University of Florida please visit the Career Paths section of the UFHR website.