Talent.com
Nemours
Coding and Billing SpecialistNemours • Orlando, FL, US
Coding and Billing Specialist

Coding and Billing Specialist

Nemours • Orlando, FL, US
7 days ago
Job type
  • Full-time
Job description
Nemours is seeking a Coding and Billing Specialist in Orlando, FL Assesses documentation for each service rendered in the hospital's place of service, in order to accurately code principal diagnoses (i.e.
preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida's enhanced ambulatory grouping.
This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e.
soft vs.
hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact; assessment and entry of surgical charges (i.e.
supplies, implants), and pharmacy charges (i.e.
contrast, patient supplied, etc). Essential Functions Ability to comprehend medical record documentation to accurately assign codes for both concurrent and discharged accounts across multiple specialties. Meets minimum requirements for production and quality monthly. Requires a working knowledge of code sequencing for grouper-related payers with attention to detail to avoid rework and waste with charge capture assessment component. Requires understanding and application of M.E.A.T.
criteria (i.e., monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses. Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion (i.e., missing charges from anesthesia, surgery) when manual charge capture occurs. 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.
(i.e., varying modifier assignment for EAPG vs.
Non-EAPG payer specificity) Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to maintain certification (i.e., CCS, CPC, RHIT, or RHIA) and apply ICD 10 CM Coding Guidelines specific to both inpatient and outpatient encounters. Facilitate modifications to clinical documentation through query interaction to ensure that the information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC), and risk adjustment factors (RAF). Demonstrates an excellent working knowledge of hospital information systems to retrieve data specific information (i.e., order diagnosis, patient type) within a complicated filing schema including non-hospital data (i.e., Media Tab, Office Visits etc) Requirements Associate's degree required Medical Terminology, Anatomy and Physiology One of the following: CPC, CCS, RHIT, RHIA, COC; Preferred CRC 3-5 years expereince About Us Nemours Children's Health is an internationally recognized pediatric health system serving more than 1.7 million patient encounters each year.
We deliver care across six states through two freestanding children's hospitals - Nemours Children's Hospital, Delaware and Nemours Children's Hospital, Florida - along with a network of more than 80 primary, urgent, and specialty care practices and more than 40 hospital partnerships. Backed by the Nemours Foundation and Alfred I.
duPont Trust, our $1.7B nonprofit system is dedicated to improving children's health through clinical care, research, education, advocacy, and prevention.
Our Whole Child Health approach focuses equally on prevention and treatment, partnering with communities to help every child thrive. Inclusion and belonging guide our strategy and growth.
We are committed to culturally relevant care, reducing health disparities, and fostering an environment where every associate, patient, and family feels supported and valued. Learn more at Nemours.org .
Create a job alert for this search

Coding and Billing Specialist • Orlando, FL, US

Similar jobs

Billing Specialist (71199)

Women's CareWinter Park, FL, United States
Full-time

Billing SpecialistWomen's Care, founded in 1998, is a leading women's healthcare group in the United States, dedicated to providing the highest quality of care for women through their reproductive ... Show more

 • Promoted

Legal Billing Specialist

Greenberg TraurigOrlando, FL, United States
Full-time

Join Our Revenue Management Team as a Billing SpecialistWe are seeking a highly skilled professional who thrives in a fast-paced, deadline-driven environment.The ideal candidate possesses strong pr... Show more

 • Promoted

eBilling Specialist

Greenberg TraurigOrlando, FL, United States
Full-time

Join Our Revenue Management Team as an EBilling SpecialistWe are seeking a highly skilled professional who thrives in a fast-paced, deadline-driven environment.The ideal candidate possesses strong ... Show more

 • Promoted

Remote Inpatient Coding Specialist

Texas Health Huguley FWSOrlando, FL, United States
Remote
Full-time

OverviewRemote Inpatient Coding Specialist (Job Number :25018724)Job DetailsSchedule :Full TimeShift :DaysLocation :AdventHealth OrlandoThe community you'll be caring for :AdventHealth OrlandoLocat... Show more

 • Promoted

Remote Billing & Traffic Coordinator

Morgan & Morgan, P.A.Orlando, FL, United States
Remote
Full-time

A leading law firm is seeking a Billing Specialist and Traffic Coordinator for a remote opportunity.This role involves invoice reconciliation, vendor budget monitoring, and ensuring compliance with... Show more

 • Promoted

Billing Analyst

Outcomes Operating, Inc.Orlando, FL, United States
Full-time

Orlando Office - ORLANDO, FL 32809.This individual will work closely with and serve as a key resource to the Accounting Projects Manager.Broadly defined, the Billing Analyst will work with the prod... Show more

 • Promoted

Billing Specialist II

Careers Integrated Resources IncOrlando, FL, United States
Full-time

Billing Specialist IiRequires 1-3 years of pharmacy billing, data management, and customer service experiencePlease let me know if you are available/interested so we can further discuss this positi... Show more

 • Promoted

Billing Manager

Akerman LLPOrlando, FL, United States
Full-time

Founded in 1920, Akerman is recognized as one of the nation's premier law firms, with more than 700 lawyers across the United States.Akerman LLP is seeking a Billing Manager to oversee and manage t... Show more

 • Promoted

Specialist, Fund/Client Accounting

BNYLake Mary, FL, United States
Full-time

Associate - Hedge Fund Accounting.We're seeking a future team member for the role of Associate to join our Hedge Fund Accounting team.This role location is Lake Mary, Florida (4 days in office expe... Show more

 • Promoted

Specialist, Fund/Client Accounting I

BNYLake Mary, FL, United States
Full-time

Associate to Join Private Equity Team.We're seeking a future team member for the role of Associate to join Private Equity Team.This role is located in New York, NY (4 days in office expectation).In... Show more

 • Promoted

Billing Specialist

Careers Integrated Resources IncOrlando, FL, United States
Full-time

Billing SpecialistDuration:4monthsLocation:Orlando FL 32812 Hours:Shift:11:30 a.Requirements/CertificationsRequires 1-3 years of Pharmacy billing, data management, and customer service experience.Y... Show more

 • Promoted

Billing Manager - Corporate

Foley & Lardner LLPOrlando, FL, United States
Full-time

Foley & Lardner LLP is seeking a Billing Manager to lead our Business Law billing team.The Billing Manager is responsible for strategically designing, implementing, and continuously enhancing the b... Show more

 • Promoted

CareIQ Billing Specialist

CorVelOrlando, FL, United States
Full-time

CareIQ Billing SpecialistThe CareIQ Billing Specialist completes invoicing processes for all CareIQ Ancillary Healthcare services.Utilizing proprietary systems and knowledge from training, a CareIQ... Show more

 • Promoted

Team Lead Enrollment and Billing

HealthfirstLake Mary, FL, United States
Full-time

Team Lead, Enrollment & Billing.The Team Lead, Enrollment & Billing is responsible for overseeing production for a defined line of business at Healthfirst.The Team Lead, Enrollment & Billing is dir... Show more

 • Promoted

Billing Specialist (70968)

Women's CareOrlando, FL, United States
Full-time

Billing SpecialistWomen's Care, founded in 1998, is a leading women's healthcare group in the United States, dedicated to providing the highest quality of care for women through their reproductive ... Show more

 • Promoted

Billing Coordinator - AR and Therapy Focused

Westminster RetirementOrlando, FL, United States
Full-time +1

Billing Coordinator - AR and Therapy FocusedThe Billing Coordinator computes, classifies, records, and verifies numerical data used in maintaining proper accounting records at the communities.Medic... Show more

 • Promoted

Remote Inpatient Coding SpecialistOrlando, FL

AdventHealthOrlando, FL, United States
Remote
Full-time +1

AdventHealth Orlando Inpatient CoderAt AdventHealth Orlando, what started as a converted farmhouse in rural Central Florida has become Central Florida's major tertiary health care facility.Patients... Show more

 • Promoted

Senior Specialist, Fund Accounting

BNYLake Mary, FL, United States
Full-time

Senior Specialist, Fund Accounting.We're seeking a future team member for the role of Senior Specialist to join our Hedge Fund Accounting Team.The position is located in Lake Mary, Florida.In this ... Show more

 • Promoted

Physician Coding Auditor

Orlando HealthOrlando, FL, United States
Full-time +1

The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and privat... Show more

 • Promoted

Remote Inpatient Coding Specialist

AdventHealth Orlando SupportOrlando, FL, United States
Remote
Full-time

Our promise to you :Joining AdventHealth is about being part of something bigger.It's about belonging to a community that believes in the wholeness of each person, and serves to uplift others in bo... Show more