Coder II: Coding

Hoag•Newport Beach, CA

13h•$36 - $55

About The Position

The Coder II reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM codes to support diagnoses, procedures, and treatment results. Coding supports billing, internal and external reporting, research, and regulatory compliance. The role follows AHIMA ethical coding standards and official coding guidelines, verifies that ICD-10-CM codes and physician information are correctly captured, keeps current with coding guideline changes, and participates in quality review meetings. For Hoag Hospital, the role resolves billing-related errors, supports workflow changes and process-improvement projects, identifies chargeable items and facility levels for emergency department visits, and codes outpatient procedures, emergency department services, and observation services. Coder II staff may assist fiscal coders or billers with account edits and collaborate with the Fiscal Coder or Revenue Cycle Team on correct coding and modifier assignments. Remote work may be possible if technology, productivity, and quality requirements are met and the Telecommuter Work Agreement is signed and followed. For Hoag Clinic, the role follows coding conventions, serves as a coding consultant to providers and a subject matter resource to other coding staff, identifies discrepancies that may affect care quality or billing, and completes coding charge reviews and claim edits in Epic or another appropriate EMR. This work includes coding and correcting ICD-10 codes, modifiers, CPT, E/M, and procedure codes. The role is expected to meet an ongoing accuracy standard of at least 95%.

Requirements

High school diploma or equivalent.
For Medical Coding - Hoag Hospital: completion of a certified coding program or graduation from a CAHIM-accredited HIT program.
For Medical Coding - Hoag Hospital: two years of hospital acute-care emergency and/or outpatient-procedure and same-day-surgery experience.
For Coding - Hoag Clinic: at least two years of work experience as a medical coder.
For HASCH: two years of experience.
Required certifications vary by coding assignment: CCS for Medical Coding - Hoag Hospital; CPC, COC, CCS-P, CCS, or CPMA for Coding - Hoag Clinic; HCS-D, CCS, or CPC for Home Health; CCS-P, CPC, or COC for HASCH Administration; and CCS or CIRCC for Cath Lab/IR.
Meet applicable productivity and quality requirements, including a 95% or better accuracy rate.

Nice To Haves

For Hoag Clinic: coding experience in multiple specialties, including areas such as OB/GYN, Urology, Oncology, Pain Management, Cardiology, General Surgery, Cardiothoracic, Neurosurgery, Neurology, and Orthopedics procedures.
Knowledge of E/M coding.
Graduate of a CAHIM-accredited HIT program and CCS-eligible or RHIT-eligible.
Spine and Ophthalmology experience.
For Coding - Hoag Clinic: Certified Urology Coder (CUC).

Responsibilities

Review clinical documentation and diagnostic results and apply appropriate ICD-10-CM codes.
Verify that ICD-10-CM codes and physician information are correctly captured.
Follow AHIMA ethical coding standards and official coding guidelines.
Keep current with coding guideline changes through self-study, assigned education, meetings, and in-services.
Participate in internal and external quality review meetings.
Resolve billing-related errors and assist with workflow changes and process-improvement projects.
Identify chargeable items and facility levels for emergency department visits, including observation services.
Assign codes for diagnoses, treatment, procedures, outpatient procedures, and emergency department services.
Assist fiscal coders or billers with front-end or back-end account edits requiring coding review.
Collaborate with the Fiscal Coder or Revenue Cycle Team to review coding and modifier assignments.
Serve as a coding consultant to Hoag Clinic providers and as a resource and subject matter expert for other coding staff.
Identify discrepancies that may affect quality of care or billing.
Complete coding charge reviews and claim edits in Epic or another appropriate EMR, including coding and correcting ICD-10 codes, modifiers, CPT, E/M, and procedure codes.
Meet ongoing productivity and quality standards, including an accuracy rate of 95% or better.
Perform other duties as assigned.