[Hiring] Coder III : Medical Coding @Hoag

Role Description

The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines.

• Verifies that all ICD-10-CM and CPT codes are correctly captured.
• Verifies that physician is correctly abstracted.
• Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance, or related in-services.
• Participates in internal and external quality review meetings.
• Performs other duties as assigned.
• Resolves billing-related errors and assists with workflow changes and process improvement projects.
• Meets ongoing productivity and quality standard of 95% accuracy rate or better.
• Assigns codes for diagnoses, treatment, and procedures for inpatient surgeries.
• Determines the correct principal diagnosis, co-morbidities, complications, secondary conditions, and surgical procedures.
• Abstracts correctly all required information from record including the correct discharge disposition and OSHPD required information.
• Assigns correct MS-DRG and APR-DRG and correct Present on Admission (POA) indicators and identifies (HAC) Hospital Acquired Conditions.
• Queries physicians per established policy and procedure when documentation is not clear or conflicting.
• Follows all coding conventions and serves as a coding consultant to Hoag providers.
• Identifies discrepancies that may impact quality of care and/or billing issues.
• Serves as a resource and subject matter expert to other coding staff.
• Completes coding charge review and claim edits in Epic or other appropriate EMR system.
• Reviews and communicates with providers on E/M Leveling/Coding.
• Codes specialty specific outpatient surgeries/same day procedures.

Qualifications

• Experience in medical coding.
• Knowledge of ICD-10-CM, ICD-10-PCS, and CPT coding systems.
• Ability to maintain a high level of accuracy in coding.
• Strong communication skills.
• Ability to work collaboratively with healthcare providers.

Requirements

• Must meet ongoing productivity and quality standard of 95% accuracy rate or better.
• Must participate in internal and external quality review meetings.
• Must keep abreast of coding guideline changes.

Benefits

• Comprehensive health care services.
• Opportunities for professional development.
• Supportive work environment.

Company Description

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers, and a network of more than 1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit, and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News & World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.