HIM Coder III

Tucson Medical Center; Tucson, Northern (AZ, KY); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Tucson Medical Center, located in Tucson, AZ, seeks a skilled HIM Coder III to assign ICD-10-CM/PCS, CPT, and HCPCS codes for inpatient and outpatient records, ensuring accurate documentation and compliant reimbursement.

Responsibilities include using 3M 360, CAC, and Epic systems, reviewing charts, maintaining 95% coding accuracy, and supporting the coding team with timely, accurate data to optimize revenue and compliance.

Qualifications

• Completion of a 2-year college or technical school curriculum in Health Information Management; 4-year preferred.
• Five years of acute care hospital coding experience required.
• RHIT, RHIA, CCS, CCS-P, CPC, CIC or COC certification required/licensure.

Responsibilities

• Assigns ICD-10-CM/ICD-10-PCS, CPT or HCPCS codes from documentation in the medical record.
• Code inpatient or outpatient records; outpatient coding includes multiple areas (emergency, same day surgery, observation, etc.).
• Follow current coding guidelines and use 3M 360, CAC, and Epic for accurate coding.
• Ensure documentation supports accurate coding and reimbursement; assist providers and staff with coding questions.
• Determine the sequence of diagnoses per UHDDS standards.
• Input data into systems to support reporting to payers, regulators, and physicians.
• Maintain policies for medical record coding and stay current with coding conventions.
• Maintain a 95% coding accuracy rate and 95% weekly utilization productivity.
• Review charts returned by payers for issues.
• Adhere to organizational safety, confidentiality, values and standards.

Skills

ICD-10 coding knowledge

Medical terminology

Data management

Task organization

Communication skills

Regulatory literacy

multi-tasking

Education

2-year health information management program

4-year health information management (preferred)

Tools

3M 360

CAC

Epic

Job description

HIM Coder III

Job Category: Clerical

Schedule: Full time

Shift: 1 - Day Shift

SUMMARY

Provides timely and accurate administrative and clinical data through the accurate assignment of current ICD-10-CM/PCS, CPT or HCPCS codes while complying with the regulations and requirements of the Federal Government, State licensing agencies and the Hospital’s policies and procedures. Supports TMCH’s management planning process and ensures appropriate reimbursement for services.

ESSENTIAL FUNCTIONS

Assigns the correct ICD-10-CM, ICD-10-PCS, CPT or HCPCS codes to each diagnosis and operative procedure substantiated by documentation contained in the medical record utilizing the current code sets.

Responsible for accurately coding inpatient or outpatient record types. For outpatient, must be able to code a minimum of four of the following independently: emergency, same day surgery, observation, pain clinic, wound clinic, diagnostics and recurring accounts.

Follows departmental and current official coding guidelines to ensure consistent and accurate coding of diagnostic and procedural data.

Utilizes the 3M 360, CAC (Computer Assisted Coding), Epic, and any other necessary applications for proper coding, ensuring accuracy.

Ensures that the medical staff documents have sufficient information for accurate coding and appropriate reimbursement, requesting clarification from the provider when information is incomplete. Assists physicians, their office staff, quality management and other hospital personnel with coding and DRG/APC questions.

Determines the sequence of diagnoses according to UHDDS (Uniform Hospital Discharge Data Set) standards.

Inputs abstract data and codes into computer to gather administrative and clinical data for distribution to outside regulatory agencies, third party payers, administrative staff and physicians.

Ensures that institutional policies and procedures for maintenance of medical records are followed. Maintains current knowledge of coding principles and guidelines as coding conventions are updated.

Maintains a 95% coding accuracy rate. Achieves average weekly utilization productivity of 95% of standard.

Reviews charts that have been returned by payers for challenges.

Adheres to TMC organizational and department-specific safety, confidentiality, values, policies and standards.

Performs related duties as assigned.

MINIMUM QUALIFICATIONS

EDUCATION: Completion of a 2-year college or technical school curriculum in Health Information Management, or an equivalent combination of relevant education and experience. Preferred is the completion of a 4-year college curriculum in Health Information Management.

EXPERIENCE: Five (5) years of acute care hospital coding experience required.

LICENSURE OR CERTIFICATION: Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS), or Certified Coding Specialist-Physician-based (CCS-P), or Certified Professional Coder (CPC), or Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC).

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of current ICD-10-CM and ICD-10-PCS codes, APC reimbursement models, UHDDS sequencing and DRG payment methodologies, including both MS-DRGs and APR-DRGs.
• Knowledge of medical terminology.
• Skill in the coding of medical information and maintaining databases to ensure accuracy.
• Skill in organizing tasks to ensure the timely and accurate coding of information.
• Skill in both oral and written communication.
• Ability to read, analyze and interpret professional journals, governmental regulations, and coding guidelines.
• Ability to follow written and verbal instructions.
• Ability to maintain good working relationships and communication with the medical staff, nursing, administration, and other ancillary departments with the hospital.
• Ability to perform multiple tasks and ensure completion to meet strict deadlines.