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Memorial Healthcare System · 2 weeks ago

Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible

Miramar, FL

Full-time

Hybrid

Entry Level

1+ years exp

Memorial Healthcare System is dedicated to improving health and quality of life for the community. They are seeking a Coder I to review medical record documentation, assign codes to medical diagnoses and procedures, and ensure proper billing and compliance.

Health Care

H1B Sponsor Likely

Responsibilities

Enhances and maintains coding knowledge and skills

Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes

Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding

Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments

For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding

Submits daily productivity report to HIM manager by defined deadline

Meets and maintains HIM coding quality and productivity standards

Attends internal and external educational meetings and seminars to maintain certification and continuing education requirements

May assign and sequence basic CPT (Current Procedural Terminology) procedure codes (non-complex), and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures

Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments

Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity

Researches medical record for any additional diagnoses documented to meet medical necessity

Communicates with insurance companies about coding errors and disputes (physician billing)

Abstracts pertinent data points for billing and quality reviews

Communicates with various departments as needed to ensure accuracy of patient data

Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM coding procedures and processes

Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing)

For physician billing, collaborates with billing department to ensure all bills are satisfied

For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing

Makes appropriate coding corrections, when advised, and follows procedure to notify billing

Qualification

Medical Record CodingCertified Coding Associate (CCA)Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)Health Information Management (HIM)Medical TerminologyCPT CodingCustomer ServiceEffective CommunicationTeam WorkCritical Thinking

Required

High School Diploma or Equivalent (Required)

Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA)

Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA)

Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA)

Registered Health Information Technician (RHIT) - State of Florida (FL)

Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA)

For HIM coder, one (1) year hospital-based outpatient coding experience

For Physician Billing Coder, one (1) year diagnostic/procedural office coding experience with surgical coding experience or six (6) months working within the Memorial Health System

Proficient in basic computer skills

Ability to perform job duties using an electronic medical record system

Strong knowledge of anatomy, physiology and medical terminology

Knowledge of coding classification systems and procedures

Preferred

For HIM: Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA)

For Physician Billing: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCSP) by AHIMA

For Hospital Billing: Certified Coding Specialist (CCS), Certified Coding Associate (CCA) or Certified Professional Coder (CPC)

Company

Memorial Healthcare System

Be at the heart of exceptional care.

Founded in 1953

Easton, Maryland, USA

10001+ employees

http://www.memorialregional.com

H1B Sponsorship

Memorial Healthcare System has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (7)

2024 (15)

2023 (4)

2022 (3)

2021 (4)

2020 (4)