Billing, Certified Coding Specialist (CCS), Clinical Study Publications, Code Reviews, Current Procedural Terminology (CPT), Data Entry, Documentation, Health Information Management, Healthcare Common Procedure Coding System (HCPCS), High School Diploma, Hospital, ICD-9, ICD-9-CM, Information Technology & Information Systems, Leadership, Medical Billing, Medical Coding, Medical Record System, Medical Records, Mentoring, Registered Health Information Technician (RHIT)
In this role you will be:
- Review medical records and clinical documentation to assign accurate and complete diagnosis and procedure codes.
- Apply knowledge of coding systems (ICD-9-CM, ICD-9-PCS, CPT, HCPCS) and coding guidelines (AHA Coding Clinic, CPT Assistant, etc.) to ensure proper code selection.
- Abstract and enter coded data into electronic health record (EHR) and hospital information systems for billing and reporting purposes.
- Ensure compliance with federal, state, and payer-specific coding regulations and hospital policies.
- Work closely with providers and clinical documentation improvement (CDI) teams to clarify ambiguities or incomplete documentation.
- Maintain productivity and coding accuracy benchmarks as defined by the department.
- Support audits and quality reviews by coding leadership or external bodies.
- Assist with mentoring or training junior coding staff as needed.
- Stay updated on coding changes, regulatory updates, and continuing education requirements.
OTHER DUTIES
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
QUALIFICATIONS
Required:
EDUCATION: High school graduate or equivalent, associate's or bachelor's in health information management or related field preferred
EXPERIENCE:
3 years coding in acute care hospital or physician office setting with multiple specialties preferred
Experience with data entry required
LICENSURE/CERTIFICATION:
Certified coding specialist (CCS) preferred or registered health information technician (RHIT) required
Completion of the IRMC outpatient coding competency test
I
Indiana Regional Medical Center