Medical Necessity Coder, Medical Necessity Management, FT,09A-5:30P

Baptist Health; Miami (FL); On-site; USD 27,579 - 35,032; Full time

Benefits offered by this job

Career growth and development

Health and wellness resources

Wellness program to reduce deductible

Tuition reimbursement

Job summary

Baptist Health in Florida seeks a skilled Health Information Management coder to ensure accurate ICD‑CM coding and CPT procedures with compliance to CMS guidelines. You will screen services for Medicare/Medicaid coverage and act as a knowledge resource for internal and external customers.

The ideal candidate has an associate degree in HIM or CSC certification, with 1–2 years outpatient coding experience and bilingual abilities preferred.

Qualifications

• Thorough knowledge of ICD‑CM, CPT, medical necessity, and DRG systems.
• Screen Medicare/Medicaid services to determine coverage and eligibility.

Responsibilities

• Assess CMS guidelines compliance and determine coverage/eligibility.
• Assist internal and external customers as a reference on coding matters.
• Communicate coverage and documentation requirements clearly to teams.

Skills

Medical terminology

Anatomy

Physiology

ICD-CM coding

CPT procedures

DRG

Bilingual

Education

Associate Degree in Health Information Management

Certified Coding Specialist program

Two years outpatient coding experience

Tools

Medical coding software

CMS verification systems

Job description

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels our commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we're all in.

Benefits

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.

Description

Thorough working knowledge of current ICD‑CM coding system, CPT procedures, medical necessity, medical terminology, anatomy, physiology, and prospective payment system (DRG’s). Screen all services for Medicare and Medicaid patients to comply with the Center for Medicare and Medicaid Services (CMS) guidelines in order to determine coverage, eligibility and ensure beneficiary notification when service(s) may not be covered. Ability to work and serve as a reference to internal and external customers. Estimated pay range for this position is $20.02 - $25.43 / hour depending on experience.

Qualifications

• High School, Cert, GED, Trn, Exper.

Additional Qualifications

• Required completion of an accredited Certified Coding Specialist program or Associate Degree in Health Information Management Science with two years outpatient coding experience.
• CPC or CCS preferred.
• ART or R.
• R.
• A.
• eligible.
• Thorough working knowledge of medical terminology, anatomy, physiology, current ICD‑CM coding systems, and CPT.
• Competency in computer applications, medical necessity verification systems, and prospective payment system (DRG’s).
• Ability to communicate effectively with external customers.
• Bilingual highly preferred.

Minimum Required Experience: 1 Year

EOE, including disability/vets