HIM Coder - Professional

DaMar Staffing; United States; On-site; USD 65,000 - 80,000; Full time

Job summary

Southern Ohio Medical Center is seeking a Health Information Management Coder – Professional to code and charge professional visits in a hospital setting. You will review charges in Meditech, determine E/M levels, and ensure accurate ICD-10 and CPT coding with HCC risk adjustments.

The role requires two years of coding experience or completion of an accredited coding program, plus CPC/CCS-P/RHIA/RHIT certification within 1 year of hire. Equal opportunity employer.

Qualifications

• Two years of coding and charging experience required or completion of an accredited coding course.
• Professional coder certification (CPC/CCS-P/RHIA/RHIT) by May 3, 2026 or within 1 year of hire.
• Must review ICD-10 diagnoses and CPT codes and apply HCC/risk coding concepts.
• Ability to code and charge professional visits and review charges in Meditech.

Responsibilities

• Confirms, verifies and adds charges for reimbursable high-dollar supplies and ensures documentation supports charges on professional claims.
• Determines sequence of diagnoses and E/M level based on guidelines and CPT codes.
• Understands anatomy, physiology, pharmacology and medical terminology to assure coding accuracy.
• Assigns and abstracts codes from orders and records to the HDM after validation in the code finder.
• Assists with denial management of professional denials related to coding or charging.
• Maintains productivity and quality standards and passes the coding competency test with 80% or higher.

Skills

ICD-10 & CPT coding

HCC/Risk Adjusted Coding

Medical terminology

Two years coding experience

Education

CPC/CCS-P/RHIA/RHIT certification

HIM coding coursework

Job description

Health Information Management Coder - Professional

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:

• 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.

• Confirms, verifies and adds charges as necessary for reimbursable high dollar supplies and ensures that documentation supports the charges captured on professional claims.
• 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.
• Understands the human anatomy, physiology, pharmacology and medical terminology to assure coding and charging accuracy on professional claims.
• 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.
• Assists with denial management of professional denial that are coding or charging related.
• Maintains productivity and quality standards as set per work type comparable to national averages and benchmarks.
• Maintains a passing score on the annual HIM 'professional' coding competency test at 80% or higher that includes HCC coding rules and guidelines.
• Assists in Meditech ambulatory registrations.
• 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.