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Ohiohealth

Faith-based nonprofit health system with hospitals

Coder 2

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

About the Job

Requirements

  • High school diploma or GED is required.
  • Completion of a two-year program and coding certification from AHIMA or AAPC, and/or graduation from a health information management program with RHIA or RHIT certification.
  • Demonstrated knowledge of ICD-9, ICD-10, and CPT-4 classification systems, advanced anatomy and physiology, medical terminology, ambulatory reimbursement schemes, and CMS Local Coverage Determination and/or National Coverage Determination guidelines.
  • Demonstrated advanced knowledge and expertise in general surgery coding, including complex surgical procedures, interpretation of operative reports, surgical anatomy, CPT coding guidelines, modifier application, and National Correct Coding Initiative edits.
  • Ability to independently review, interpret, and accurately code complex general surgery cases, resolve coding discrepancies, and apply coding guidelines while maintaining compliance and accuracy standards.

Responsibilities

  • Assign appropriate admit, reason-for-visit, principal and secondary ICD-9, ICD-10, and CPT-4 diagnoses and/or procedures by reviewing medical-record documentation and applying coding guidelines appropriate to the hospital service and patient type, while meeting the required quality and productivity standards.
  • Assign CPT modifiers for facility coding when necessary.
  • Review records for diagnoses that meet medical necessity for diagnostic and surgical procedures according to CMS Local Coverage Determination and/or National Coverage Determination guidelines.
  • Identify when physician clarification is needed because documentation is inadequate, ambiguous, or unclear for coding purposes.
  • Code and charge clinic accounts accurately, including assigning facility evaluation and management levels using the Ohio Health Scorecard.
  • Retrieve documentation supporting account coding from non-HIM department source systems, including GE Gentricity and Mosaic.
  • Assist educators and supervisors in reviewing accounts denied by RAC and other governmental payers to determine whether documentation supports the original coding.
  • When documentation is insufficient, missing, or conflicting, assign transaction codes in the HBOC system and follow department policy for follow-up and physician queries.
  • Abstract data elements needed to complete UB-04 and meet hospital reporting requirements.
  • Verify demographics, correct account numbers, charges, and services, and identify missing or incorrect forms in each record.
  • Identify problem cases on the DNFB and forward them to appropriate staff for follow-up.
  • Perform other duties as requested by the supervisor.

About the Company

Ohiohealth

Faith-based nonprofit health system with hospitals

OhioHealth operates a not-for-profit, faith-based health system with 16 hospitals and 200+ care sites across 50 Ohio counties, supported by 35,000+ staff and volunteers. It provides inpatient, urgent, primary, and specialty care through its network. It coordinates care across hospitals, clinics, and specialty centers to serve communities. Its goal is to improve the health of people in its communities by providing accessible, comprehensive healthcare rooted in its mission and community focus.

Company size
Not listed
Company stage
Not listed
Total funding
$13.9M
Headquarters
Columbus, OH
Founded
Not listed

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