Coder III : Medical Coding

Primary Duties And Responsibilities

• The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM and ICD-10-PCS to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health information Management Association (AHIMA) and adheres to all official coding guidelines.
• Verifies that all ICD-10-CM codes are correctly captured.
• Verify that physician is correctly abstracted.
• Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services.
• Participates in internal and external quality review meetings.
• Performs other duties as assigned.

Medical Coding - Hospital Based

• Resolves billing related errors and assists with workflow changes and process improvement projects.
• Meets ongoing productivity and quality standard of 95% accuracy rate or better.
• Additionally, the Coder III assigns codes for diagnoses, treatment, and procedures for inpatient surgeries.
• Determines the correct principal diagnosis, co-morbidities, complications, secondary conditions, and surgical procedures.
• Abstracts correctly all required information from record including the correct discharge disposition and OSHPD required information.
• Also assigns correct MS-DRG and APR-DRG and correct Present on Admission (POA) indicators and identifies (HAC) Hospital Acquired Conditions.
• Queries physicians per established policy and procedure when documentation is not clear or conflicting.

Education and Experience

High school diploma or equivalent required.

Medical Coding - Hoag Hospital:

• Completion of a certified coding program or graduate of a CAHIM accredited HIT program required.
• Five years of progressive inpatient coding experience in an acute care facility.

Coding - Hoag Clinic: Required:

• Five or more (5+) years coding experience mastering assigning diagnostic and procedure codes to patient medical records.
• Must have extensive outpatient coding experience in multiple areas of specialty.

Certifications Required

• Certified Coding Specialist (CCS)