HIM Coder - Professional

Southern Ohio Medical Center; Portsmouth (OH); On-site; USD 52,000 - 76,000; Full time

Job summary

Southern Ohio Medical Center in Portsmouth, OH seeks an HIM Coder – Professional to code and charge medical office visits for professional claims. The role requires ICD-10 and CPT coding accuracy, E/M level determination, and applying HCC/risk coding concepts to ensure correct patient risk scores.

The candidate should have a high school diploma, completion of a coding training program, and HIM coder certification by May 3, 2026 or within 1 year of hire.

Qualifications

• High School Diploma or equivalent required.
• HIM Coder – Professional/HCC exam within 6 months of hire.
• Medical terminology course completed.
• Anatomy & physiology course preferred.
• Formal coding training program preferred.

Responsibilities

• Code and charge professional claims for office visits.
• Review and edit charges in Meditech; ensure correct CPT/ICD-10 sequencing.
• Apply HCC/risk coding to assign accurate risk scores.
• Assigns and abstracts codes from orders to HDM after validation.
• Assist with denial management of professional denials.
• Maintain productivity and quality to national benchmarks.
• Pass coding competency test annually (≥80%).
• Assist in Meditech ambulatory registrations.
• Perform other duties as assigned.

Skills

Medical coding

HCC coding

CPT coding

E/M coding

Education

High School Diploma

HIM Coder – Professional/HCC exam

Medical terminology

Anatomy & physiology

Formal coding training

Tools

Meditech

Code finder

Job description

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

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) throughAHIMA 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.

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.