Overview Medical coding roles requiring accurate ICD-10-CM coding to support diagnoses, procedures, and treatment outcomes. Adheres to AHIMA Ethical Coding standards and official coding guidelines. Roles may include responsibilities across hospital, clinic, and outpatient settings with opportunities for remote work where applicable. Primary Responsibilities The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Adheres to AHIMA Ethical Coding standards and official coding guidelines. Verify that all ICD-10-CM codes are correctly captured and that physician abstraction is accurate. Stay updated on coding guideline changes through self-study, education, coding meetings, or related in-services. Participate in internal and external quality review meetings. Performs other duties as assigned. Medical Coding – Hoag Hospital Resolve billing-related errors and support workflow changes and process improvement projects. Meet ongoing productivity and quality standards (e.g., 95% accuracy or better). Identify chargeable items and facility level for emergency department visits. Assign codes for diagnoses, treatment, and procedures for Outpatient Procedures. Assign codes for the Emergency Department and identify chargeable items and facility level for ED visits, including observation services. Assist Fiscal Coder or Biller with front-end or back-end edits as needed. Collaborate with the Revenue Cycle Team to ensure correct coding and modifier assignment. May work remotely if minimum technology requirements, productivity and quality standards are met and the Telecommuter Work Agreement is signed and adhered to. Coding – Hoag Clinic Meet ongoing productivity and quality standards (e.g., 95% accuracy). Follow coding conventions and serve as a coding consultant to Hoag providers. Identify discrepancies that may impact quality of care or billing. Act as a resource and subject-matter expert for other coding staff. Complete coding charge review and claim edits in Epic or other EMR systems, including coding and correcting ICD-10 codes, modifiers, CPT, E/M, and procedure codes. Qualifications Education and Experience High school diploma or equivalent required. Completion of a certified coding program or graduation from a CAHIM-accredited HIT program required. Hoag Hospital – Two years (2) of hospital acute care Emergency and/or Outpatient procedures, and same-day surgery experience. Coding – Hoag Clinic Required: Minimum 2+ years of work experience as a medical coder. Preferred: Coding experience across multiple specialties (including OB/GYN, Urology, Oncology, Pain Management, Cardiology, General Surgery, Cardiothoracic, Neurosurgery, Neurology, Orthopedics) and knowledge of E/M coding. HASCH – 2 years’ experience required. Graduate of a CAHIM-accredited HIT program with CCS eligible or RHIT eligible preferred. Spine and Ophthalmology experience preferred. Certifications Medical Coding – Hoag Hospital: Certified Coding Specialist (CCS). Coding – Hoag Clinic: CPC, COC, CCS-P, CCS, or CPMA. Home Health: HCS-D, CCS, or CPC. HASCH Administration: CCS-P, CPC, or COC. Cath Lab/IR: CCS or CIRCC. Licenses – N/A About Us Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, with multiple hospitals, centers, and thousands of staff and providers. Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to equal employment opportunity for all employees and providing a work environment free of discrimination and harassment. For more information, visit Hoag’s official website. Note: This job description reflects the current responsibilities and qualifications and is subject to change at the organization’s discretion. #J-18808-Ljbffr