HIM Coder - Professional

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process.

Department: Health Information Management
Shift/schedule: Full Time (40 hrs/wk)

GENERAL SUMMARY

Works under the supervision of the HIM Manager (Operations & Auditing).  The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims.  Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting.  Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately.  Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient.  Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines.  Performs other duties as assigned.

QUALIFICATIONS

Education:

• High School Diploma or successful completion of an equivalent High School Exam Required
• Successful completion of the HIM Coder – Professional/HCC competency exam within 6 months of hire required
• Successful completion of medical terminology course required
• Successful completion of an anatomy and physiology course preferred
• Successful completion of a formal coding training program preferred

Licensure:

• Professional Coder certification (CPC, CCS-P, RHIA or RHIT) through AHIMA or AAPC by May 3, 2026 -or- within 1 year of hire required

Experience:

• Two years of coding and charging experience required, -or- successful completion of an accredited coding course.
• HCC/Risk Adjusted Coding experience preferred

JOB SPECIFIC DUTIES AND PERFORMANCE EXPECTATIONS

The following is a summary of the major job duties of this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.

1. Confirms, verifies and adds charges as necessary for reimbursable high dollar supplies and ensures that documentation supports the charges captured on professional claims.

2. Determines sequence of diagnoses according to set guidelines for professional coding, including HCC coding guidelines and determines E/M level based on published criteria, accuracy of CPT procedure codes and other services provided in the professional office.

3. Understands the human anatomy, physiology, pharmacology and medical terminology to assure coding and charging accuracy on professional claims.

4. Assigns and abstracts codes from outpatient orders and electronic records to HDM after confirming the validity of the code in the code finder as well as reviewing confirmed test results for the most accurate code assignment.

5. Assists with denial management of professional denial that are coding or charging related.

6. Maintains productivity and quality standards as set per work type comparable to national averages and benchmarks.

7. Maintains a passing score on the annual HIM 'professional' coding competency test at 80% or higher that includes HCC coding rules and guidelines.

8. Assists in Meditech ambulatory registrations.

9. Performs other duties as assigned.

Why SOMC? You Care for Our Patients, We Care for You

At Southern Ohio Medical Center, our mission is to make a difference in the community we serve. We're committed to delivering exceptional care and that starts with our team members. When you join SOMC, you're not just starting a job. You're joining a mission.

Compensation & Benefits

• Competitive pay with quarterly market analysis
• Performance-based annual increase and bonus eligibility
• Up to 4% employer contributions to retirement plans (403(b) and Cash Balance Pension)
• Comprehensive medical, dental, and vision coverage*
• Medical and dependent care flexible spending accounts*
• Earned Wage Access - get paid before payday
• Paid Time Off bank with 3 annual sick days
• Life insurance and disability coverage*
• Tuition and certification assistance
• Club LC - discounted/free gym membership
• Employee discount and payroll deduct programs
• And many other benefit offerings!

*Available only to Full-Time and/or Part-Time Employees

Compensation & benefit eligibility is determined by employment status, position type, and hours worked. Offerings are subject to change and governed by SOMC's current plan documents and policies. Specific details will be reviewed upon hire as part of the onboarding process.

Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position in accordance with applicable law. A full job description is available upon request.

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Southern Ohio Medical Center is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to age, ancestry, color, disability, ethnicity, gender identity, or expression, genetic information, military status, national origin, race, religion, sex, gender, sexual orientation, pregnancy, protected veteran status or any other basis under the law.