Hospital Based Outpatient Coder II - HIM - FT - Days - MSS - Remote Eligible

CO010 Memorial Healthcare System; United States; Remote; USD 55,000 - 85,000; Full time

Job summary

Memorial Healthcare System in Miramar, FL, is seeking a qualified HIM coder to review medical records, assign ICD-10-CM codes and CPT/HCPCS modifiers for outpatient encounters, ensuring accurate coding for billing and compliance.

The role requires CCS, RHIA or RHIT certifications and hospital outpatient coding experience. Candidates should maintain AHIMA standards and communicate effectively with providers and billing teams.

Qualifications

• High School Diploma or Equivalent required.
• Certified Coding Specialist (CCS) per AHIMA.
• Registered Health Information Administrator (RHIA) per AHIMA.
• RHIT certification (FL).
• RHIT AHIMA certification required or preferred.

Responsibilities

• Review and code hospital outpatient encounters to ensure accurate ICD-10-CM, CPT/HCPCS coding and modifiers.
• Audit and correct coding to meet AHIMA standards and CMS regulations.
• Maintain confidentiality and comply with HIM policies across inpatient and professional billing.
• Prepare queries for physicians to improve documentation and coding accuracy.

Skills

Accountability

Accuracy

Medical terminology

Communication

Documentation

Decision making

Education

High School Diploma or Equivalent

CCS - AHIMA

RHIA - AHIMA

RHIT - FL

RHIT AHIMA

Tools

Encoder software

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 to assign ICD-10 CM codes to complex diagnoses and CPT codes and modifiers to procedures for outpatient encounters to ensure proper coding, billing, and compliance.

Responsibilities

For hospital encounters, 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 chargemaster generated CPT/HCPCS codes, when errors are found Coding Management is notified to alert Charge Management to educate department making errors. Makes appropriate coding corrections when advised and follows procedure to notify billing. For Professional Billing, routes to billing charge entry errors and/ or account edits preventing completion of coding and/or billing. Enhances and maintains coding knowledge and skills for physician billing. Maintains strict adherence to patient confidentiality according to MHS standards and regulatory requirements. Communicates with insurance companies about coding errors and disputes for physician billing. Reviews and validates accuracy of data in Admission-Discharge-Transfer (ADT) fields following HIM coding policies and procedures. Reviews CRW (Certified Social Worker) documentation to assign correct discharge disposition, notify coding management when clarification needed. Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements. Adjusts and adapts to continual changes in the coding field. Practices ethical coding per AHIMA Standards of Ethical Coding. Meets and maintains HIM coding quality and productivity standards. Submits daily productivity report to HIM manager by defined deadline. Reviews encounters to assign and sequence appropriate diagnoses (including HCC Coding Hierarchical Condition Category) and CPT procedure codes as well as modifiers to complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP), guidance in encoder software and HIM coding policies and procedures. Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments. Reviews coding edits. Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity. Research electronic medical record for any additional diagnoses documented to meet medical necessity. Codes various OP service lines for all MHS specialties that include encounters with high complexity of surgical procedures and assign anesthesia procedure codes (hospital) following specific payer requirements. Reads and interprets all provider documentation which includes all dictated, scanned, and electronically created documents, imaging, pathology reports, and labs pertaining to admission. Reviews all appropriate work queues daily to address edits and make corrections following Health Information Management (HIM) coding policies and procedures. Conducts, audits and/or coding reviews with various health care professionals to ensure all documentation is accurate for physician billing. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Create electronic physicians queries within allowed scope for hospital outpatient coder.

Competencies

• ACCOUNTABILITY
• 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 - OP CODING
• RESPONDING TO CHANGE
• STANDARDS OF BEHAVIOR

Education and Certification Requirements

• High School Diploma or Equivalent (Required)
• 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 including Microsoft Office applications, computerized encoder, and electronic medical record systems. Ability to perform job duties using an electronic medical record system. Requires a strong proficiency and understanding of Medical Terminology, Anatomy & Physiology, Pathophysiology and Pharmacology. Knowledge of coding classification systems and procedures. Possesses a strong foundation in coding and clinical knowledge with ability to review, research and code diagnoses and procedures with a high level of complexity.

Required Work Experience

• For HIM coder, two (2) years of hospital-based outpatient coding experience or a graduate of the internal MHS Coder Intern Program.
• For Physician Billing coder, two (2) years of higher complexities of diagnostic/procedural/office coding experience.

Other Information

Additional Education Info: For HIM, completion of coding training program. Additional Certification Info: For HIM: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS). For Physician Billing: Certified For Physician Billing, Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, Certified Coding Specialist (CCS), or Certified Coding Specialist - Physician Based (CCSP) by AHIMA.

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 = 80% Hearing Acuity = 80% 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: Primarily for office workers - not eligible for shift differential

Veteran’s Preference

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, 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 elsewhere. What if there are two equally qualified, preference-eligible job applicants? In this case, the selection is based on the eligibility category in accordance with Florida law. First preference is given to: An honorably discharged veteran who has served on active duty and has a service‑connected, compensable disability. A spouse of a person who has a total, permanent, service‑connected disability and cannot qualify for employment. A spouse of a person missing in action, captured or forcibly detained or interned by a foreign government or power. What do I do if I am denied Veteran's Preference? If you feel you have been unfairly denied Veteran’s Preference by Memorial Healthcare System, please contact [e-mail]. You may also file a complaint with the Florida Department of Veterans’ Affairs (FDVA). All information provided in connection with your application for employment will be a public record and subject to release upon request, unless considered exempt or confidential.