[Hiring] Outpatient Surgical and Observation Coder @Nemours Children's Health

Role Description

Join our team as a Coding and Billing Specialist! Role responsibilities include:

• Assessing documentation for each service rendered in the hospital’s place of service.
• Accurately coding principal diagnoses, 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
• Drug administration for specified service lines impacting Florida’s enhanced ambulatory grouping
• Excellent working knowledge of revenue charge capture and its impact on hospital billing.
• Assessment and entry of surgical charges and pharmacy charges.

Applicants must reside in one of the following states:

• Alabama
• Colorado
• Delaware
• The District of Columbia
• Florida
• Georgia
• Illinois
• Maryland
• Missouri
• New Jersey
• New York
• North Carolina
• Ohio
• Pennsylvania
• South Carolina
• Tennessee
• Texas
• Virginia

Responsibilities:

• 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.
• Requires understanding and application of M.E.A.T. criteria using ICD 10 CM transaction data set.
• Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion.
• Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews.
• Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to maintain certification.
• Facilitate modifications to clinical documentation through query interaction.
• Demonstrates an excellent working knowledge of hospital information systems to retrieve specific data.

Qualifications

• Minimum education of an Associate's degree required.
• Medical Terminology, Anatomy and Physiology required.
• One of the following certifications required: CPC, CCS, RHIT, RHIA, COC (please include on resume).

Company Description

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.
• A network of more than 80 primary, urgent, and specialty care practices.
• 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 .