Job Description

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.

Active - Benefit Eligible and Accrues Time Off

Work Hours per Biweekly Pay Period: 80.00

Shift : Flexible Hours and/or Flexible Schedule

Location : 210 South Florida Avenue Lakeland, FL

Pay Rate : Min $19.37 Mid $24.22

Position Summary

Under the direction of the Coding and Clinical Documentation Improvement Manager, reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, Physician Advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract. Participates in ongoing continued education to assure knowledge and compliance with annual changes.

Position Responsibilities

People At The Heart Of All That We Do

• Fosters an inclusive and engaged environment through teamwork and collaboration.
• Ensures patients and families have the best possible experiences across the continuum of care.
• Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

• Behaves in a mindful manner focused on self, patient, visitor, and team safety.
• Demonstrates accountability and commitment to quality work.
• Participates actively in process improvement and adoption of standard work.

Stewardship

• Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
• Knows and adheres to organizational and department policies and procedures.

Standard Work Duties: Coder II - Outpatient

• Assigns and sequences diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding
• Abstracts and enters coded data as well as correct surgeon, anesthesiologist and procedure date. Assures appropriate information such as pathology and operative reports are present in the medical record prior to final coding for coding accuracy and appropriate APC assignment.
• Maintains appropriate level of coding and abstracting productivity and quality for outpatient diagnostic, Emergency Department, Family Health Center, ambulatory surgeries, observations, and other recurring services as per established minimum per hour requirement.
• Demonstrates competence in coding and abstracting requirements by maintaining less than 5% error rate for all ICD-10-CM and/or PCS, CPT, and HCPCS codes and modifiers.
• Continuously reviews changes in coding rules and regulations including in Coding Clinic, CPT Assistant, CMS, and other payer guidelines.
• Prioritizes coding functions as directed by the Manager, and organizes job functions and work assignments to efficiently complete tasks within the established time frames.
• Demonstrates knowledge of all equipment and systems/technology necessary to complete duties and responsibilities.
• Works collaboratively with the Discharge Not Final Billed (DNFB) clerks to prioritize workload daily.
• Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.
• Reviews appropriate outpatient work queues daily to address coding reviews, edits and corrections.

Competencies & Skills

Essential:

• Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
• Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision.
• Knowledge of anatomy and physiology, pharmacology, and medical terminology.

Qualifications & Experience

Essential:

• High School or Equivalent

Nonessential:

• Associate Degree

Essential:

• High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.

Other information:

Certifications Essential: CCS

Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).

Experience Essential:

2-5 years acute care hospital outpatient coding experience within the past five years, or 5-7 year's experience in a multi-disciplinary clinic including surgeries and/or Emergency Department coding.

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