Certified Coder - Out-Patient

Coast Plaza Doctors Hospital; Norwalk (CA); On-site; USD 75,000 - 110,000; Full time

Job summary

Pipeline Health is seeking an Inpatient & Outpatient Coder to ensure accurate coding for both inpatient and outpatient encounters while maintaining a 95% accuracy rate. The role emphasizes timely OSHPD data submissions, adherence to HIPAA, and strong communication with the care team to support efficient reimbursement and quality patient care.

The candidate should have at least 2 years in acute care coding, with solid knowledge of ICD-10CM/PCS and CPT coding.

Qualifications

• Minimum 2 years of experience in an acute care or inpatient setting.
• Strong understanding of ICD-10CM/PCS and CPT coding.
• Experience with OSHPD data elements and discharge data.
• Ability to maintain high coding accuracy (target 95%).
• Demonstrates HIPAA compliance and professional communication.
• Able to manage multiple priorities and meet deadlines.

Responsibilities

• Assigns ICD-10CM/PCS and CPT codes using chart documentation.
• Ensures coding compliance with current regulations.
• Maintains OSHPD data submissions and accuracy.
• Achieves 95% coding accuracy and productivity metrics.
• Collaborates with department staff to minimize discharge backlog.
• Participates in monthly trainings and exhibits AIDET principles.

Skills

ICD-10CM/PCS coding

CPT coding

OSHPD data definitions

AIDET communication

HIPAA compliance

Job description

Description

Job Summary: The Inpatient & Outpatient Coder plays a vital role in ensuring accurate and timely coding of medical records for both inpatient and outpatient encounters, contributing to efficient reimbursement and optimal patient care. They maintain a 95% coding accuracy rate and current, up-to-date knowledge of coding rules and regulations. Actively and consistently contributes to department operations and communications, behaves in a manner consistent with the mission, vision, and values of Pipeline Health, upholding standards of AIDET (Acknowledge, Introduce, Duration, Explanation, Thank you) patient communication.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.

Essential Functions:

• Assigns ICD-10CM/PCS and CPT (Current Procedural Terminology) codes using appropriate source documents within the medical record.
• Assigns ICD-10CM/PCS and CPT codes in compliance with current coding regulations.
• Completes at a minimum ten (10) Continuing Education Units (CEUs) per year.
• Assigns diagnostic and procedural codes to outpatient ancillary/recurring visits, emergency department, same day surgery or inpatient records as needed.
• Maintains an average coding accuracy rate of 95%.
• Maintains productivity rate of four (4) inpatient charts per hour and five (5) outpatient surgery charts per hour.
• Prioritizes workload volume appropriately by coding and abstracting the oldest accounts first. Codes any account with charges greater than $50,000 before the oldest accounts.
• Maintains productivity rate of 20 ER’s (Emergency Rooms), 27 ancillary, or 5 newborn records per hour.
• Abstracts data elements from discharge records onto hospital’s patient information system using state-mandated data definitions (OSHPD) with an average accuracy rate of 98%.
• Participates in timely submission of OSHPD patient data semiannually.
• Participates in correction of OSHPD discharge data edits and correction report as needed.
• Maintains an accuracy rate of 100% in assigning disposition codes on all Medicare transfer DRGs (Diagnosis-Related Groups).
• Works collaboratively with department coordinator and clerical staff in ensuring that DNFB (Discharge, Not Final Billed) is within the Corporate and Departmental guidelines of four (4) days or less from date of discharge.
• Ensures that all reports relative to performance improvement for the coding functions are timely.
• Uses clear, concise, professional communication with coworkers, patients, all customers internal and external.
• Uses AIDET in interactions with patients and family members.
• Acts with a sense of urgency when performing tasks.
• Basic unit/department maintenance such as keeping files, drawers, cabinets free from unnecessary clutter.
• Reports on any equipment and or environmental issues for repair.
• Abides by HIPAA (Health Insurance Portability and Accountability Act) regulations.
• Speaks up to stop the line and escalates potential safety events if necessary.
• Completes and attends monthly training assigned.
• Other duties as assigned.

Behavioral Standards:

• Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service; Expresses recognition and shows appreciation to others; fully utilizes AIDET principles; responds quickly to handle requests, complaints, and questions; displays a positive attitude.
• Demonstrates the highest level of professionalism, passion and care when interacting with patients, families, physicians, and hospital staff members.
• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential, embracing ingenuity to service our customers.

Communication/Knowledge:

• Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect; respects customer’s and co-worker’s time; establishes and maintains effective relationships with customers and co-workers.
• Attends staff meetings; follows HIPAA guidelines; follows patient rights policy; complies with the compliance program; demonstrates knowledge of role in a disaster; demonstrates knowledge of fire and fire drill procedures; working knowledge of hospital emergency codes; always utilizes standard precautions in the clinical setting; safely manages the environment of care by demonstrating a working knowledge of the requirements of the: Life Safety program, Utilities Management program, Hazardous Materials program, Emergency Preparedness program, Safety Management program, Medical Equipment Management program, Security Management program.

Qualifications/Experience:

• Minimum 2-years of experience in an acute care or inpatient setting.
• Critical thinking, service excellence and good interpersonal communication skills, ability to read/comprehend written instructions, strong organizational skills, ability to follow verbal instructions, and PC (computer) skills.
• A capacity to learn, synthesize, make critical judgments, work independently, place patients and families first, and collaborate with the team members who are recognized leaders within health care.

Qualifications

Licenses & Certifications

Required

CCS Cert Coding Specialst

Preferred

Equal Opportunity Employer
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