University of Southern California · 1 week ago
Coder Editor, HIM - HIM Financial - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
TWP The Walnut Plaza
Full-time
Onsite
Entry Level
$39/hr - $63.95/hr
1+ years expUniversity of Southern California is seeking a Coder Editor for their Health Information Management (HIM) department. The role involves ensuring compliance with coding regulations and accurately coding medical records to facilitate billing and reimbursement processes.
EducationHigher EducationUniversities
Responsibilities
Perform ‘denial prevention’ functionalities by researching, editing, & correcting all coding edits and/or coding issues Re: all diagnostic and procedural information from the medical records using OCE/NCCI, CMS Transmittals, MAC Transmittals, Medicare Claims Processing Manuals, ICD-10-CM, ICD-10-PCS, and CPT/HCPCS, and Modifier classification systems and abstracting patient information as established and required by official coding laws, regulations, rules, guidelines, and conventions
Perform ‘denial management’ functionalities, processes, research, editing, & correction to recover reimbursements previously denied by payers
Reviews the entire medical record; accurately classify and sequence diagnoses and procedures; ensure the capture of all documented conditions that coexist at the time of the encounter/visit, all medical necessity diagnoses, complications, co-morbidities, historical condition or family history that has an impact on current care or influences treatment, and all external causes of morbidity
Enter patient information into inpatient and outpatient medical record databases (ClinTrac/HDM). Ensures accuracy and integrity of medical record abstracted UB-04 & OSHPD data elements prior to billing interface and claims submission
Works cooperatively with HIM Coding Support and/or Clinical Documentation Improvement Specialist in obtaining documentation to complete medical records and ensure optimal and accurate assignment of diagnosis & procedure codes
Attendance, punctuality, and professionalism in all HIM Coding and work related activities
Consistently assumes responsibility and displays reliability for completion of tasks, duties, communications and actions. Completes tasks accurately, legibly, and in a timely fashion
Ability to achieve a minimum of 95% editing/coding accuracy rate as determined by any internal or external review of coding and/or department quality review(s)
Ability to achieve a minimum of 95% abstracting accuracy rate of UB-04 and OSHPD data elements as determined by any internal or external review of coding and/or department quality review(s)
Assist in ensuring that all medical records contain medical necessity information required for optimal and accurate coding and abstracting
Recognizes education needs of based on monthly reviews and conducts self-improvement activities
Ability to act as a resource to coding and hospital staff on coding issues and questions
Ability to improve MS-DRG assignments specific to CDI documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions
Ability to improve APR-DRG, SOI, and ROM assignments specific to CDI documentation & coding of PDx, SecDx, CC/MCC, PPx, and SecPx in accordance with official coding laws, regulations, rules, guidelines, and conventions
Ability to improve APC/HCC assignments based on medical necessity documentation & coding of PDx, SecDx, and CPT/HCPCS in accordance with official coding laws, regulations, rules, guidelines, and conventions
Maintains at minimum, expected productivity standards (See HIM Practice Guidelines) and strives to maintain a steady level of productivity and provides consistent effort
Works coding queues/task lists to ensure 95% of patient bills are dropped within 5 days after patient discharge/date of service
Works coding queues/task lists to ensures the remaining 5% of patient bills are dropped within 2 weeks of discharge/date of service
Assist other coders in performance of duties including answering questions and providing guidance, as necessary
Assists Patient Financial Services (PFS), Patient Access, and other departments in addressing coding issues/questions and/or providing information so that an interim bill can be generated. Assists with physicians, physician office staff and hospital ancillary department staff with diagnostic or procedural coding issues/questions, as needed
Assists in the monitoring unbilled accounts to ensure that the oldest records are coded and/or given priority
Maintains AHIMA and or AAPC coding credential(s) specified in the job description
Attend coding & CDI seminars, webinars, and in-services to maintain the required annual continued education units (CEU)
Keep up-to-date and reviews ICD-10 Official Guidelines for Coding & Reporting, AHA Coding Clinic, and CPT Assistant to maintain knowledge of the principles of coding
Keep up-to-date and reviews other professional journals and newsletters in a timely fashion to maintain knowledge of the principles of coding
Consistently attend and actively participate in the daily huddles
Consistently adhere to HIM policies and procedures as directed by HIM management
Demonstrates an understanding of policies and procedures and priorities, seeking clarification as needed
Participates in continuously assessing and improving departmental performance
Ability to communicate changes to improve processes to the director, as needed
Assists in department and section quality improvement activities and processes (i.e. Performance Improvement)
Works and communicates in a positive manner with management and supervisory staff, medical staff, co-workers and other healthcare personnel
Ability to communicate effectively intra-departmentally and inter-departmentally
Ability to communicate effectively with external customers
Provides timely follow-up with both written and verbal requests for information, including voice mail and email
Working knowledge and efficient navigation of the Electronic Health Record (EHR): Cerner/Powerchart & Coding mPage
Working knowledge, efficient navigation, & full use of 3M-CRS Encoder system; utilize to expedite coding process; utilize all references
Knowledge & understanding of PFS system (PBAR) functionality and any interface with the coding abstracting system: ClinTrac
Working knowledge, efficient navigation, & full use of ‘HDM/HRM/ARMS Core’ coding & abstracting software
Working knowledge, efficient navigation, & full use of ‘3M 360 Encompass/CAC’
Performs other duties as assigned
Qualification
Required
High school or equivalent
Specialized/technical training College courses in Medical Terminology, Anatomy & Physiology and a certified coding course. Successful completion of the hospital specific Coding Test – with a passing score of ≥70%. The coding test may be waived for former USC or agency/contract HIM Coding Department Coders who historically/previously met the ≥ 90% internal/external audit standards of the previously held USC Job Code
1 year Experience in ICD-9 & ICD-10 (combined) and CPT/HCPCS coding of ambulatory surgery medical records in hospital or outpatient surgical center, and experience in using a computerized coding & abstracting database software and an encoding/code-finder systems
Knowledge of medical terminology
Organization/time management skills
Demonstrate excellent customer service behavior
Able to function independently and as a member of a team
Working knowledge of CPT, HCPCs and ICD9 coding principles
Company
University of Southern California
University of Southern California is a private research university offering opportunities for interdisciplinary study and collaboration.
10001+ employees
H1B Sponsorship
University of Southern California 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)
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Represents job field similar to this job
Trends of Total Sponsorships
2025 (253)
2024 (239)
2023 (172)
2022 (207)
2021 (182)
2020 (195)
Funding
Current Stage
Late StageTotal Funding
$19.64MKey Investors
Patient-Centered Outcomes Research InstituteCalifornia Institute for Regenerative MedicineCDA Foundation
2025-02-04Grant· $10.8M
2025-01-30Grant· $5.93M
2024-07-30Grant
Leadership Team
David A Barnhart
Director, USC Space Engineering Research Center
H
Hossein Pourmand
Assistant Vice President, Research Initiatives, University Advancement
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