Coder III : Medical Coding

Hoag Health System; Newport Beach (CA); On-site; USD 85,000 - 120,000; Full time

Job summary

Hoag Memorial Hospital Presbyterian seeks an experienced Coder to review clinical documentation and apply ICD-10-CM/PCS codes for inpatient care. The role emphasizes accurate abstraction, adherence to AHIMA guidelines, and participation in quality reviews.

Candidates should have a high school diploma, a certified coding program or CAHIM HIT credential, and at least five years of inpatient coding at an acute care facility, with CCS certification preferred.

Qualifications

• High school diploma or equivalent required.
• Completion of a certified coding program or CAHIM-accredited HIT program.
• Five+ years of progressive inpatient coding experience in an acute care facility.
• Experience with coding for specialties and surgeries.
• Certified Coding Specialist (CCS) certification.

Responsibilities

• Review clinical documentation and apply ICD-10-CM/PCS codes to support diagnoses, procedures, and treatment results.
• Verify all ICD-10-CM codes are correctly captured and that physician abstraction is accurate.
• Stay updated on coding guideline changes through self-study and trainings.
• Participate in internal and external quality review meetings.
• Resolve billing related errors and support workflow/process improvements.
• Abstract required information from records including discharge disposition and POA indicators.

Skills

Inpatient coding experience

Medical record abstraction

Specialties and surgeries coding

Education

High school diploma or equivalent

Certified coding program or CAHIM HIT program

Job description

• 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.

Job Description

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.

Qualifications

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 or more of progressive inpatient coding experience in an acute care facility.
• Experience with coding for specialties and surgeries

Certifications Required

• Certified Coding Specialist (CCS)

About Us

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/ .

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.