Reviews medical record documentation to assign ICD-10-CM codes, CPT codes, and modifiers for outpatient encounters to ensure proper coding, billing, and compliance.
Responsible for reviewing hospital and professional billing encounters, correcting coding-related errors, validating ADT data, and supporting accurate physician billing. Uses encoder software, EMR systems, and work queues to review APC/EAPG assignments, coding edits, LCD guidance, and medical necessity documentation.
Works with healthcare providers and billing teams to clarify documentation, supports charge management education, and maintains productivity, quality, and confidentiality standards. Participates in ongoing education to stay current with coding regulations, payer requirements, and ethical coding practices.
Education and certification
- High school diploma or equivalent required
- Completion of a coding training program for HIM roles
- One of the following certifications preferred/required depending on role:
- CCS
- RHIA
- RHIT
- CPC
- CPMA
- CRC
- CCSP
Experience
- 2 years of hospital-based outpatient coding experience for HIM coder roles, or graduation from the internal MHS Coder Intern Program
- 2 years of higher-complexity diagnostic, procedural, or office coding experience for Physician Billing coder roles
Skills and knowledge
- Strong knowledge of medical terminology, anatomy and physiology, pathophysiology, and pharmacology
- Understanding of coding classification systems, official coding guidelines, CMS regulations, and payer-specific requirements
- Experience using encoder software and electronic medical record systems
- Ability to review complex diagnostic and surgical documentation and assign diagnoses and procedures accurately
- Strong critical thinking, communication, and independent decision-making skills
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
3 weeks ago