HIM Coder - Professional

DaMar Staffing; Portsmouth (OH); On-site; USD 55,000 - 75,000; Full time

Job summary

Southern Ohio Medical Center is seeking a HIM Coder - Professional to code and charge professional visits in a clinic setting. You'll review charges in Meditech, apply ICD-10 and CPT codes, and ensure accurate E/M levels and HCC/risk coding.

The role requires CPC/CCS-P/RHIA/RHIT certification or equivalent by May 3, 2026 or within 1 year of hire, plus two years of coding/charging experience or completed coding coursework. Equal opportunity employer.

Qualifications

• Code and bill professional visits for claims with appropriate CPT/ICD-10 coding.
• Review and edit charges in Meditech for accuracy and E/M levels.
• Apply HCC/risk coding concepts to determine risk scores.
• Maintain knowledge of ICD-10/CPT rules and professional coding guidelines.

Responsibilities

• Confirms and adds charges for reimbursable professional services.
• Determines sequence of diagnoses and E/M level per guidelines.
• Understands anatomy and terminology to ensure accurate coding.
• Assigns/ abstracts codes from records to the system after validation.
• Assists with denial management related to coding/charging.
• Maintains productivity and quality per benchmarks.
• Maintains passing score on coding competency tests (80%+).
• Performs other duties as assigned.

Skills

CPC/CCS-P/RHIA/RHIT certification

ICD-10 coding

CPT coding

HCC/risk coding concepts

Charge capture

Education

High School Diploma or equivalent

HIM Coder - Professional/HCC competency exam

Medical terminology course

Anatomy & physiology course

Formal coding training program

Tools

Meditech

Job description

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.

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.

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.

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.