Coding Specialist II (Finance)

Nemours is seeking a Coding Specialist II to join our team.

Primary Functions

Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-9-CM, and HCPCS codes.

Review Charges in Epic EMR and prepare charges for submission. Include complete information regarding diagnosis, service/procedure codes, and any additional information needed for reimbursement.

Manually charge enter charges form partner hospitals as needed.

Ensure charge capture by reviewing census and/or O.R. schedule(s) daily.

Act as a coding resource to assigned divisions.

Essential Functions

Code correctly all applicable diagnosis, procedure codes, and modifiers related to the admission, observation or procedure utilizing appropriate CPT, ICD-10, and HCPCS codes.

Prepare charges for data entry. Include complete information regarding diagnosis, service procedure codes, and any additional information needed for reimbursement.

Ensure charge capture by reviewing Census and O.R. schedule(s) daily.

Act as a coding resource to assigned divisions.

Keep abreast of all current CMS and insurance plan coding requirements.

Register off-site inpatient and outpatient demographics as needed by accurately entering patient demographic, guarantor and coverage information into EPIC

Data entry of charges into the Professional Billing computer package as needed following Charge Entry workflow and Standard Business Practice for Reconciliation of Charge Batches.

Configure and run Charge Entry report daily

Proficient in Professional Billing application(s).

Know and use data entry ground rules for data entry.

Know and follow Standard Business Practices and where to locate both hard copy and electronic versions.

Work well with DAG team to obtain necessary coverage's and/or authorizations.

Demonstrate excellent customer service that promotes patient, staff, and customer satisfaction and reflects the mission, vision, and values of Nemours.

Understand and utilize Nemours Intranet and Managed Care Manual.

Keep abreast of all insurance and system changes/updates.

Maintain strict confidentiality.

Provide support and assistance to other Coding Specialist as needed.

Maintain annual/new hire training as required.

Perform other duties as assigned by leadership.

Qualifications

High School Diploma

CPC and/or CCS-P required

3-5 years experience. Must meet annual continuing education requirements to maintain certification.