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Memorial Healthcare System

Florida not-for-profit health system delivering care

Coder 2

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeFlorida, USANo salary listed

About the Job

Requirements

  • A high school diploma or equivalent is required.
  • For a HIM coder, two years of hospital-based outpatient coding experience or graduation from the internal MHS Coder Intern Program is required.
  • For a Physician Billing coder, two years of higher-complexity diagnostic, procedural, or office coding experience is required.
  • For HIM, completion of a coding training program is required.
  • For HIM, the required certifications are Registered Health Information Technician, Registered Health Information Administrator, or Certified Coding Specialist.
  • For Physician Billing, a required certification is Certified Professional Coder, Certified Professional Medical Auditor, Certified Risk Adjustment Coder, Certified Coding Specialist, or Certified Coding Specialist—Physician Based.
  • Proficiency in basic computer skills, including Microsoft Office applications, a computerized encoder, and electronic medical record systems, is required.
  • Strong proficiency in medical terminology, anatomy and physiology, pathophysiology, and pharmacology is required.
  • Knowledge of coding classification systems and procedures is required.
  • A strong foundation in coding and clinical knowledge, including the ability to review, research, and code complex diagnoses and procedures, is required.
  • Critical thinking, effective communication, decisive judgment, and the ability to work independently with minimal supervision are required.
  • The ability to work in a stressful environment and take appropriate action is required.

Responsibilities

  • Review medical record documentation and assign ICD-10-CM codes to complex diagnoses and CPT codes and modifiers to outpatient procedures to support proper coding, billing, and compliance.
  • Use an encoder to review Ambulatory Payment Classification and Enhanced Ambulatory Patient Group assignments, coding edits, and Local Coverage Determination edits and guidance for medical necessity.
  • Research the electronic medical record for additional diagnoses documented to meet medical necessity.
  • Code various outpatient service lines across Memorial Healthcare System specialties, including highly complex surgical encounters, and assign hospital anesthesia procedure codes according to payer requirements.
  • Read and interpret dictated, scanned, and electronically created provider documents, imaging, pathology reports, and laboratory results related to the admission.
  • Review appropriate work queues daily, address edits, and make corrections in accordance with Health Information Management coding policies and procedures.
  • Conduct audits and coding reviews with healthcare professionals to ensure documentation accuracy for physician billing.
  • Communicate with insurance companies about coding errors and disputes for physician billing.
  • Review and validate Admission-Discharge-Transfer field accuracy in accordance with Health Information Management coding policies and procedures.
  • Review Certified Social Worker documentation to assign the correct discharge disposition and notify coding management when clarification is needed.
  • Attend internal and external educational meetings and seminars to maintain certification and continuing education requirements.
  • Review encounters and assign and sequence diagnoses, including Hierarchical Condition Category coding, and CPT procedure codes and modifiers for complex diagnostic and surgical encounters in accordance with Official Coding Guidelines, Centers for Medicare & Medicaid Services regulations, Local Medical Review Policy, encoder guidance, and Health Information Management coding policies and procedures.
  • Seek clarification from healthcare providers or other designated resources to ensure accurate and complete coding; create electronic physician queries within the permitted scope for hospital outpatient coding.
  • For hospital encounters, route billing charge-entry errors or account edits that prevent coding or billing completion; make advised coding corrections and notify billing according to procedure.
  • Review chargemaster-generated CPT/HCPCS codes, notify Coding Management of errors so Charge Management can educate the department, and make advised coding corrections and notify billing according to procedure.
  • For Professional Billing, route billing charge-entry errors or account edits that prevent coding or billing completion.
  • Adapt to continuing changes in the coding field and practice ethical coding in accordance with AHIMA Standards of Ethical Coding.
  • Meet and maintain Health Information Management coding quality and productivity standards and submit a daily productivity report to the HIM manager by the defined deadline.
  • Enhance and maintain coding knowledge and skills for physician billing.
  • Maintain patient confidentiality in accordance with Memorial Healthcare System standards and regulatory requirements.

About the Company

Memorial Healthcare System

Florida not-for-profit health system delivering care

Memorial Healthcare System is a large not-for-profit health system in Florida that provides a wide range of medical services through its hospitals and affiliated facilities. It delivers patient-centered care through the Memorial Experience, focusing on personalized attention and comprehensive services, and includes a hiring process with post-offer drug testing. It stands out as one of the nation’s largest not-for-profit systems with about 17,000 employees and an emphasis on diversity, Veteran’s Preference, and a defined patient experience. Its goal is to deliver exceptional, personalized care and improve the health of patients, families, and the broader community.

Company size
5,001-10,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Easton, PA
Founded
1953

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