HIM Coding & System Specialist

Aiken Regional Medical Centers

Corona (CA)

On-site

USD 60,000 - 85,000

Full time

14 days+

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Benefits offered by this job

Challenging and rewarding work

Competitive Compensation & Generous PA

Excellent Medical, Dental, Vision and

401(K) with company match

SoFi Student Loan Refinancing Program

Job summary

Universal Health Services (UHS) is seeking a Health Information Management Coding and System Specialist to manage inpatient and outpatient bill-holds and support timely coding. You will collaborate with multiple departments to resolve missing documentation, ensure data accuracy, and uphold coding ethics.

The role requires attention to detail, knowledge of OSHPD MIRCal, and experience in Medical Records with 2–3 years in a hospital setting. Strong communication with provider offices is essential.

Qualifications

High School Graduate or equivilent required.
Associate’s degree in Medical Records Science preferred.
Completion of an introductory course of Medical Terminology required.
Two (2) to Three (3) years of experience in Medical Records required, acute care experience preferred.
Prior knowledge of State and Federal release of information laws preferred.

Responsibilities

Daily operations of inpatient and outpatient bill-holds to assist Coding with productivity standards.
Identify unbilled accounts and ensure timely coding.
Research missing documentation and coordinate with departments/providers.
Collaborate with Physician Liaison to add incomplete records to suspension process.
Process coding support lists and ensure accurate data in HIM Department.
Assist with data reviews and ensure data consistency across charging/coding functions.
Maintain confidentiality and adhere to coding ethics and policies.

Skills

Medical Records

Coding

Querying providers

OSHPD MIRCal knowledge

Education

High School Graduate

Associate’s degree in Medical Records Science preferred

Medical Terminology course required

Tools

EMR system

Coding application

Job description

Responsibilities

Join the Southwest Healthcare Team!

About Us:

Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations here to serve the Southern California community. With over 6,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community.

Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including: Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho Springs Hospital, Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital, Temecula Valley Day Surgery, A+ Urgent Care Centers, Riverside Medical Clinics, and APEX Heart Specialists. For more information on how to join our dynamic team, please visit our website at www.swhealthcaresystem.com.

POSITION SUMMARY:

The Health Information Management (HIM) Coding and System Specialist collaborates with staff across the Region and is responsible for the daily operations of the Inpatient and Outpatient Bill-holds to assist the Coding section with achieving performance goals on a daily, weekly and monthly basis.

POSITION SPECIFIC RESPONSIBILITIES:

Responsible for daily working the Inpatient & Outpatient Bill-holds to assist the Coding section with obtaining the Coding Team productivity standards. The Coding Team productivity standard is met when the average unbilled days are less than 4 days out for inpatient and 5 days out for outpatient coding. This will be assessed weekly, every Thursday, at the end of business day.
Daily review Inpatient & Outpatient bill-holds to identify those accounts, which have not been coded to date.
Research reasons why accounts remain on the unbilled reports (i.e. missing diagnosis, invalid diagnosis, no physician order, records not scanned, missing documentation, etc) and follow-up accordingly to facilitate timely completion. This process requires working with other departments and contacting provider offices by telephone and fax for completion of missing documentation and coding queries. Upon completion, notify the responsible coder for final coding.
Works daily with the Physician Liaison Representative in order to ensure providers who have incomplete records affecting the bill-hold are added to the suspension process, facilitating timely record completion.
Monitor and process daily the coding support work lists, within Coding application, for all records held or released with pending receipt of incomplete/missing documentation.
Responsible for ensuring accurate data within the HIM Department as follows:
- Duplicate Patient Encounters – Researches duplicate encounter numbers when identified to validate if patient should have one encounter or two encounters. When appropriate, merges encounter data/charges in accordance with charging guidelines.
- Moving of Charges – Move charges daily when posted to the wrong account. Charges are moved to the correct account only after the accounts have been researched and charges found to be supported by record documentation. If the account has been coded or dropped, requests the Central Business Office (CBO) to re-bill the account.
- Corporate Coding Reports – Weekly works the assigned corporate reports to identify problem accounts and forward to the responsible coder for review and correction (i.e missing ED charge report, duplicate ED charge report, etc).
Assists Regional Coding Manager with projects, data reviews, etc to ensure data consistency within the charging/coding functions.
Works with fellow employees inside and outside the HIM Department to ensure timely and accurate charging and coding.
Works with clerical HIM staff and other coders to ensure a smooth workflow process to meet the requirements of the Universal Health Services, Inc. (UHS) Corporate HIM Monthly Operations Report and other HIM Department goals.
Works with the HIM Leadership to provide back-up coverage for correcting Standard Edits to ensure clean data submission to meet State of California Office of Statewide Health Planning and Development (OSHPD) guidelines for timeliness and accuracy in the submission of data. Has a working knowledge of OSHPD’s on-line Medical Information Reporting for California (MIRCal) website.
Attends all charging/coding department meetings. Responsible for taking notes and completing meeting minutes.
Maintains and protects patient confidentiality at all times.
Assists the coders in the process of querying providers appropriately according to coding compliance guidelines, UHS, and HIM Department guidelines. Utilizes telephone, fax machine and eMR message center to communicate with provider/provider’s offices.
Refers problem-coding queries to the Coding Lead for review with possible follow-up with the Regional Coding Manager, as appropriate.
Responsible to read, understand, and abide at all times by the Coder’s Code of Ethics (found in the HIM Coding Policy and Procedure).
Responsible to read current periodicals and reference materials received through the HIM Department and through UHS Corporate directives. Applies this knowledge to daily work in order to minimize errors.
Understands the appropriate documentation requirements for the medical record in order to meet Federal, State, and facility regulations. Reports documentation irregularities to the HIM Operations Manager and/or designee.
Performs other duties as assigned.

BENEFIT HIGHLIGHTS

Challenging and rewarding work environment
Competitive Compensation & Generous Paid Time Off
Excellent Medical, Dental, Vision and Prescription Drug Plans
401(K) with company match and discounted stock plan
SoFi Student Loan Refinancing Program
Career development opportunities within UHS and its 300+ Subsidiaries!

About Universal Health Services

Headquartered in King of Prussia, PA, Universal Health Services, Inc. (NYSE: UHS) is one of the nation’s largest and most respected providers of hospital and healthcare services. Since our founding in 1979, UHS has grown steadily into a premier Fortune 500® corporation perennially recognized by multiple esteemed national rating entities. Through its subsidiaries, UHS operates inpatient acute care facilities, inpatient behavioral health facilities, outpatient and other facilities, nationwide virtual behavioral health services, an insurance offering, a physician network and various related services with physical locations in the U.S., Puerto Rico, Ireland and United Kingdom. www.uhs.com.

Qualifications

EDUCATION/TRAINING/ EXPERIENCE:

High School Graduate or equivilent required.
Associate’s degree from an accredited College or University in Medical Records Science preferred.
Completion of an introductory course of Medical Terminology required.
Two (2) to Three (3) years of experience in Medical Records required, acute care experience preferred.
Prior knowledge of State and Federal release of information laws preferred.

CERTIFICATIONS/LICENSES:

Must have valid California Driver’s License and reliable transportation.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries. During the recruitment process, no recruiter or employee will request financial or personal information (e.g., Social Security Number, credit card or bank information, etc.) from you via email. Our recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc.

If you suspect a fraudulent job posting or job-related email mentioning UHS or its subsidiaries, we encourage you to report such concerns to appropriate law enforcement. We encourage you to refer to legitimate UHS and UHS subsidiary career websites to verify job opportunities and not rely on unsolicited calls from recruiters.

EDUCATION/TRAINING/ EXPERIENCE:

High School Graduate or equivilent required.
Associate’s degree from an accredited College or University in Medical Records Science preferred.
Completion of an introductory course of Medical Terminology required.
Two (2) to Three (3) years of experience in Medical Records required, acute care experience preferred.
Prior knowledge of State and Federal release of information laws preferred.

CERTIFICATIONS/LICENSES:

Must have valid California Driver’s License and reliable transportation.

EEO Statement

Avoid and Report Recruitment Scams

We are aware of a scam whereby imposters are posing as Recruiters from UHS, and our subsidiary hospitals and facilities. Beware of anyone requesting financial or personal information.

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set

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