Clinical Coder II – Student Health Care Center (CHFM) (533061)

Classification Title:

Clinical Coder II

Job Description:

The Student Health Care Center (SHCC) at the University of Florida in the Department of Community Health and Family Medicine (CHFM) seeks a dedicated full-time Clinical Coder II. This role involves handling all aspects of clinical billing and charge entry, including pre-editing charges, reviewing CPT and ICD-10 codes, ensuring codes support the chart's narrative, capturing all rendered services with accurate codes, timely submission of claims, and follow-up on denied claims. The ideal candidate will have strong knowledge of CPT and ICD-10 coding guidelines and compliance programs, including HIPAA. Flexibility to assist with other duties in the insurance department and willingness to cross-train as necessary are required. The successful candidate will also assist with various duties in the insurance department, cross-train as necessary, and serve as a mentor and resource for junior staff.

Medical Records and Coding:

• Pre-edit medical records and charges for accurate coding.
• Verify that codes are supported by written narrative.
• Ensure all services rendered are coded properly.
• Verify time is recorded for all services requiring documentation of time.
• Coordinate with providers through billing inquiries or telephone calls to make necessary corrections/additions/deletions to ensure “clean claims.”
• Submit claims on a timely basis.

 Claims and Denial Management:

• Monitor follow-up and denial work queues.
• Research problems, correct and resubmit for payment per payer guidelines and UF SHCC Compliance Program.
• Research denied lab services and disputes regarding coding for labs.
• Route decisions to PFS staff for finalization with outside labs and patients.

Audits and Quality Control:

• Responsible for annual Administrative Quality Audit of Providers.

System Software and Data Entry:

• Follow all appropriate processes regarding system software, including EPIC, for entering charge data for services provided by UF SHCC.

Professional Development:

• Maintain CPC status and stay abreast of annual coding and compliance updates through professional associations, in-house continuing education, federal and private payer notifications, and coding networks.

Mentorship and Support:

• Serve as mentor/resource for lower-level charge entry staff members.
• Assist with other duties as assigned.

Schedule: Work hours are Monday through Friday, 8 am to 5 pm. During especially busy periods or special projects, employees have the option to take on overtime, which may be available before or after regular hours, including weekends. Overtime is entirely optional and offers a great opportunity for those interested in extra hours. Additionally, the option to work from home may be available after successfully completing the probationary period.

About Gainesville, Florida:

Gainesville (http://cityofgainesville.org) is home to Florida's largest and oldest university and is one of the state's centers of education, medicine, cultural events, and athletics. Gainesville is also the largest city in Alachua County and is the county seat, with approximately 269,000 residents county-wide. The city provides a full range of municipal services, including cultural and nature services and necessary administrative services to support these activities. Additionally, the city owns a regional transit system, a regional airport, and a 72-par championship golf course. Known for its preservation of historic buildings and the beauty of its natural surroundings, Gainesville's numerous parks, museums, and lakes provide entertainment to thousands of visitors. Because of its beautiful landscape and urban "forest," Gainesville is one of the most attractive cities in Florida. It is a hidden gem in North Central Florida that is within a couple of hours of major cities such as Orlando, Jacksonville, and Tampa. We are in a central location to the Gulf of Mexico and the Atlantic Ocean, providing easy access within a day’s drive to beaches, nature preserves, and water-based activities. We have warm weather much of the year, allowing for outdoor activities almost year-round. Due to the diverse atmosphere generated by The University of Florida and UF Health Shands, who are the leading employers in Gainesville, Gainesville is also a wonderful place to raise a family. For more information about Gainesville, FL, please go to: The Guide to Greater Gainesville