Clinical Coder IV
Code and bill professional medical fees for practicing clinical faculty physicians (College of Medicine). Enter charge data entry into EPIC while ensuring clean claim submission to include working any edits that may generate and appear in the work queue. Serve as a mentor and assists in training other level coders. Complete special projects such as clinic audit requests, charge capture tasks and other duties assigned by management. 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 EPIC electronic medical records 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 and acts as an expert in assigned division within the department.
- Applies appropriate CPT and ICD-10 codes and confirms adequate teaching provider documentation.
- Responsible for charge data entry into EPIC 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.
- Serves as a mentor and assists in training other level coders.
- Works special projects such as clinic audit requests, charge capture tasks and other duties assigned by management.
- Attend continuing education courses, seminars, conferences, and meetings.
Education and Experience
High school diploma or equivalent and eight years of experience in professional medical coding, (academic medicine setting preferred), with experience with more than four 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.
To see common career pathways for each position at the University of Florida please visit the Career Paths section of the UFHR website.