Professional Fee Abstractor Position Available In Duval, Florida

Professional Fee Abstractor
Jacksonville, FL, United States (Remote)

JOB DESCRIPTION

Nemours is seeking a Professional Fee Abstractor!
Assesses each professional session (i.e. claim) for all documented conditions and application of M.E.A.T. criteria (i.e. monitoring, evaluation, assessment, treatment) to accurately apply

ICD 10 CM

codes to capture diagnoses, evaluation & management CPT codes, procedure codes, HCPCS codes and modifier application per payer specific guidelines. Ability to comprehend medical record documentation to assign codes for each active session, in multiple specialties. (i.e. Codes assigned by provider are evaluated and modified with the approval of the provider)
Codes a minimum of 60-100 sessions per shift. The number of lines per session varies, therefore, “Coding Required” sessions are completed daily.
Works collaboratively in a team setting with providers, allied health staff, business office staff throughout the enterprise to achieve accurately coded 1500 claims.
Analyzes high-risk encounters for accurate charge capture and makes recommendation before transferring to second level review work queues.
Facilitates modifications to clinical documentation to ensure that information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC) and risk adjustment factors (RAF).
Understands complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with un-clear, nonspecific, or un-substantiated care rendered. Crossover coding is expected to help in any and all professional sessions (as assigned) using written reliable methods which identifies standard work requirements by session type.
Communicates with providers directly for clarification or gaps in documentation prior to submitting the session to assign the code(s) which fit services rendered.
Maintains production and accuracy objectives (i.e. metrics) identified annually.
Job Requirements
High School Diploma required. Associate’s Degree preferred.
Minimum of three (3) to five (5) years experience required.
One of the following is required:

CCS-P, CPC, RHIA, OR RHIT

CRC, CEMC preferred.
RCC or other qualifying specialty certification
Knowledge of all state and federal regulatory requirements associated with billing and coding.

JOB INFO

Job Identification
16109
Job Category
Non-Clinical Support Staff
Posting Date
06/17/2025, 02:02 PM
Degree Level
High School Graduate
Job Schedule
Full time
Locations
10140 Centurion Parkway North, Jacksonville, FL, 32256, US
(Remote)