Hospital Based Outpatient Coder I - HIM - FT - Days - Remote Eligible

CO010 Memorial Healthcare System; United States; Remote; USD 55,000 - 75,000; Full time

Job summary

Memorial Healthcare System in Miramar, FL seeks an experienced Health Information Management (HIM) coder to review medical record documentation and assign codes for diagnoses, procedures and modifiers. The role supports hospital and physician billing and ensures compliance with coding guidelines.

The candidate should hold AHIMA certifications (CCA, CCS, RHIA, RHIT) and have hospital outpatient coding or physician billing experience, with strong attention to accuracy and data quality.

Qualifications

• High school diploma or equivalent is required.
• AHIMA certifications (CCA, CCS, RHIA, RHIT) preferred.
• Experience with hospital outpatient and physician billing coding.
• Knowledge of ICD-10-CM/PCS, CPT coding guidelines and documentation review.

Responsibilities

• Review medical records for accurate coding of diagnoses, procedures and modifiers.
• Ensure codes meet Official Coding Guidelines and CMS LMPR guidance.
• Collaborate with physicians and billing to resolve coding issues.
• Audit and validate data in ADT fields and coding classifications.
• Submit productivity reports and maintain coding quality and accuracy.
• Stay current with coding education and institutional policies.

Skills

Attention to detail

Coding knowledge

Analytical thinking

Education

CCA (AHIMA)

CCS (AHIMA)

RHIA (AHIMA)

RHIT (FL)

Job description

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.

Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.

Responsibilities

• Enhances and maintains coding knowledge and skills.
• Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes.
• Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.For physician billing, collaborates with billing department to ensure all bills are satisfied.
• For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing.
• Makes appropriate coding corrections, when advised, and follows procedure to notify billing.
• Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM coding procedures and processes.
• May assign and sequence basic CPT (Current Procedural Terminology) procedure codes (non-complex), and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures.
• Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments.
• Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity.
• Researches medical record for any additional diagnoses documented to meet medical necessity.
• Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing).
• Communicates with insurance companies about coding errors and disputes (physician billing).
• Abstracts pertinent data points for billing and quality reviews.
• Communicates with various departments as needed to ensure accuracy of patient data.
• Submits daily productivity report to HIM manager by defined deadline.
• Meets and maintains HIM coding quality and productivity standards.
• Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements.
• Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments.
• For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding.

Competencies

• ACCOUNTABILITY
• ACCURACY (DRG)
• ACCURACY - CODER
• ACCURACY - OUTPATIENT
• ANALYSIS AND DECISION MAKING
• CUSTOMER SERVICE
• EFFECTIVE COMMUNICATION
• HEALTH INFORMATION MANAGEMENT (HIM) SYSTEMS - CODER
• HEALTH INFORMATION MNGMT
• MEDICAL RECORD CODING
• MEDICAL TERMINOLOGY (1)
• PRODUCTIVITY - IP CODING
• RESPONDING TO CHANGE
• STANDARDS OF BEHAVIOR
• TEAM WORK

Education and Certification Requirements

• High School Diploma or Equivalent (Required)
• Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA)
• Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA)
• Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA)
• Registered Health Information Technician (RHIT) - State of Florida (FL)
• Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA)

Additional Job Information

Complexity of Work: Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work independently with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Proficient in basic computer skills. Ability to perform job duties using an electronic medical record system. Strong knowledge of anatomy, physiology and medical terminology. Knowledge of coding classification systems and procedures.

Required Work Experience

For HIM coder, one (1) year hospital-based outpatient coding experience. For Physician Billing Coder, one (1) year diagnostic/procedural office coding experience with surgical coding experience or six (6) months working within the Memorial Health System.

Other Information

• For HIM: Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA).
• For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCSP) by AHIMA.
• For Hospital Billing: Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC).

Working Conditions and Physical Requirements

• Bending and Stooping = 40%
• Climbing = 0%
• Keyboard Entry = 60%
• Kneeling = 40%
• Lifting/Carrying Patients 35 Pounds or Greater = 0%
• Lifting or Carrying 0 - 25 lbs Non-Patient = 40%
• Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
• Lifting or Carrying > 75 lbs Non-Patient = 0%
• Pushing or Pulling 0 - 25 lbs Non-Patient = 40%
• Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
• Pushing or Pulling > 75 lbs Non-Patient = 0%
• Reaching = 40%
• Repetitive Movement Foot/Leg = 0%
• Repetitive Movement Hand/Arm = 60%
• Running = 0%
• Sitting = 60%
• Squatting = 40%
• Standing = 60%
• Walking = 60%
• Audible Speech = 60%
• Hearing Acuity = 60%
• Smelling Acuity = 0%
• Taste Discrimination = 0%
• Depth Perception = 60%
• Distinguish Color = 60%
• Seeing - Far = 60%
• Seeing - Near = 60%
• Bio hazardous Waste = 0%
• Biological Hazards - Respiratory = 0%
• Biological Hazards - Skin or Ingestion = 0%
• Blood and/or Bodily Fluids = 0%
• Communicable Diseases and/or Pathogens = 0%
• Asbestos = 0%
• Cytotoxic Chemicals = 0%
• Dust = 0%
• Gas/Vapors/Fumes = 0%
• Hazardous Chemicals = 0%
• Hazardous Medication = 0%
• Latex = 0%
• Computer Monitor = 80%
• Domestic Animals = 0%
• Extreme Heat/Cold = 0%
• Fire Risk = 0%
• Hazardous Noise = 0%
• Heating Devices = 0%
• Hypoxia = 0%
• Laser/High Intensity Lights = 0%
• Magnetic Fields = 0%
• Moving Mechanical Parts = 0%
• Needles/Sharp Objects = 0%
• Potential Electric Shock = 0%
• Potential for Physical Assault = 0%
• Radiation = 0%
• Sudden Decompression During Flights = 0%
• Unprotected Heights = 0%
• Wet or Slippery Surfaces = 0%

Shift: Days Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.

Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.

Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity. Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law. We are proud to offer Veteran’s Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program. Employment is subject to post offer, pre-placement assessment, including drug testing.

If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email [e-mail]

Be where care matters. At Memorial Healthcare System, we are dedicated to improving the health, well-being, and quality of life of the people entrusted to our care. This unwavering commitment to our service vision makes the difference and is the foundation of The Memorial Experience. Deeper Caring. Smarter Healthcare. Talk to our patients and their families about “Deeper Caring,” and they'll tell you stories about miracle babies, lives saved through sheer determination, and the comforting kindness of others. About people who advocated for the family’s best interests and cared for them in body, mind, and spirit. For our employees, “Smarter Healthcare” means constantly improving how we deliver care. It could be a new technology, a streamlined process, or a cutting-edge program leveraging our system strengths. But, no matter how you look at it, our service vision is integral to our culture today and what we strive to be tomorrow. We invite you to share in the Memorial Experience – where touching lives, lifting spirits, and healing the human body is our profession’s greatest privilege and reward. Be where you are valued.

Memorial Healthcare System provides preference as part of our commitment to honoring the service and sacrifice of veterans in alignment with state regulations. Veteran’s Preference allows for the first choice in interviewing, hiring, retention, and promotion after deployment when all other applicant qualifications are equal. However, Veteran's Preference does not guarantee a job. Who is eligible for Veteran’s Preference? We are proud to offer preference to internal and external applicants who identify within these categories: veterans, disabled veterans, spouse of a disabled veteran, unremarried veteran widow/widower, certain family members, active reservists and members of the National Guard.

What should I do if I am eligible for Veteran’s Preference? You must claim your Veteran’s Preference status on your application. If selected for a job, you must provide documentation regarding your status. How does Memorial verify that someone is eligible for Veteran’s Preference? We require specific documentation as determined by the basis for which someone claims preference. For example, the documentation for a disabled veteran is different from the documentation required for the spouse of a veteran killed in the line of duty. How often can an eligible person claim Veteran's Preference at Memorial? There is no limit to how often internal or external applicants can use preference when a job is posted externally on our career website or