The Coder (Hospital Billing) reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM and ICD-10-PCS codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. The coder follows Ethical Coding standards set by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
Responsibilities include verifying ICD-10-CM and ICD-10-PCS codes, ensuring physician and key information is correctly abstracted, resolving billing errors, assisting workflow improvements, meeting a productivity and accuracy rate of 95% or better, assigning codes for inpatient surgeries including principal diagnosis and complications, abstracting required information including discharge disposition and HCAI data, assigning MS-DRG and APR-DRG codes, Present on Admission indicators, and identifying Hospital Acquired Conditions. Queries physicians when documentation is unclear or conflicting, keeps updated on coding guidelines through self-study and education, participates in quality review meetings, and works effectively with coding and Clinical Documentation Improvement teams.
Qualifications:
- High school diploma or equivalent.
- Completion of a certified coding program or graduate of a CAHIM accredited Health Information Technology program.
- Five years of progressive inpatient coding experience in an acute care facility.
Preferred:
- Adept coding experience in multiple specialties such as OB/GYN, Urology, Oncology, Pain Management, Cardiology, Neurology, and Orthopedics.
- Strong clinical knowledge of disease processes and related procedures.
- Experience working with EPIC Electronic Medical Records (EMR).
Certifications:
- Required: Certified Coding Specialist (CCS).
- Preferred: Certified Urology Coder (CUC).
Hoag Health System is a nonprofit regional healthcare network in Orange County, CA, with multiple hospitals and health centers, delivering personalized care and ranked highly in U.S. news for California hospitals.
- High school diploma or equivalent.
- Completion of a certified coding program or graduate of a CAHIM accredited HIT program.
- Minimum five years progressive inpatient coding experience in acute care.
- Certified Coding Specialist (CCS) certification required.
- Preferred experience coding in multiple specialties including OB/GYN, Urology, Oncology, Pain Management, Cardiology, Neurology, Orthopedics.
- Preferred Certified Urology Coder (CUC).
- Experience with EPIC EMR system preferred.
- Strong understanding of medical terminology, pathology, physiology, and coding guidelines.
Location
California, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago