30 Him Coding jobs in the United States

Under the direction of the Health Information Management (HIM) Supervisor of Coding Education, the HIM Coding Educator - Outpatient provides training, education, and mentoring to the outpatient coding team and outpatient CDI team for coding education. You will work with business owners to define, plan, implement, and evaluate the training required to ensure smooth change management for coding operations, revenue cycle, and affected areas. This role is responsible for evaluating and delivering comprehensive training and education programs related to the end-user's needs.

The HIM Coding Educator - Outpatient provides onsite and/or virtual support for trainees and is a knowledge resource for all staff. You will collect and coordinate data collection by performing coding quality chart reviews, ensuring the reviews meet government, regulatory, and coding guidelines/standards. You are responsible for delivering the results of these chart reviews with reports that can be used to make informed business decisions that are accurate, relevant, and error-free.

Annual Salary Range: $63,169.60 - $93,184.00

This position is a remote position.

Qualifications

Education:

• Requires an associate degree in health information management or a related field or an equivalent combination of training and progressively responsible experience that will result in the required specialized knowledge and abilities to perform the assigned work.
• A bachelor's degree in health information management or related field is preferred.

• Must have a minimum of five (5) years of progressively responsible healthcare acute care coding involving outpatient facility coding experience, demonstrating a strong understanding of the required knowledge, skills, and abilities.
• Must have Level 1 Trauma coding experience, coding experience in a teaching hospital, and Electronic Health Record experience.
• Prefer Burn coding experience and/or experience providing classroom, on-site, and/or virtual training.

• ICD-10, ICD-10 PCS, and CPT Coding and auditing experience are required.
• Prefer formal training in 3M products/ Epic/Auditing/CDI/Revenue Cycle.

• Requires certification as a CCS, CCS-P, CPC, CPC-H, CPC-P, CIC, or COC.
• Preferred dual certification as a Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT).

• Requires extensive knowledge and experience in outpatient facility coding and auditing and the subject area for which they evaluate, report, and provide training.
• Must demonstrate knowledge of HIPAA privacy and security regulations as evidenced by appropriate handling of Protected Health Information (PHI), promoting confidentiality, and using discretion when handling patient and various hospital departments' information.
• Must be able to follow all Federal and State regulations, as well as all Valleywise Health policies and procedures.
• Requires a basic understanding of all functions performed by the Coding and Revenue Cycle Teams.
• Requires strong computer skills in all areas of healthcare applications, technology, education, and automated systems, as well as Microsoft Products, Epic, PwC SMART, and 3M software. This includes the ability to adapt to multiple client systems simultaneously.
• Requires a basic understanding of the standard tools, workflow processes, and/or procedures and concepts used in implementing, designing, and delivering training programs and materials.
• Prefer an understanding of healthcare business and software and a strong ability to translate administrative and operating requirements into clear, specific, and actionable curricula and then implement and teach those curriculums.
• Must demonstrate effective listening, facilitation, and presentation skills.
• Must possess excellent interpersonal and communication skills, both verbally and in writing, including knowledge of basic grammar, spelling, and punctuation.
• Must be flexible, detail-oriented, highly collaborative, and positively influence others.
• The ability to work in a team environment, as well as independently, while being willing to take ownership of responsibilities, being quality conscious, and being able to manage time effectively and adapt to change.
• Must be able to continuously listen, react, and suggest ways to complement or assist the work of others.
• Requires the ability to read, write, and speak effectively in English.

HIM Coding Specialist II role at BRONSON BATTLE CREEK. External applicants only. Current Bronson employees should apply via the Workday career worklet.

Location: BHG Bronson Healthcare Group, 6901 Portage Road

• Navigates the electronic health record and other computer systems to determine diagnoses and procedures to be coded.
• Codes hospital outpatient surgery, Interventional Radiology, observation, psychiatric, and inpatient records using encoder software in the assignment of ICD-10-CM/PCS, CPT-4, and HCPCS codes for appropriate MS-DRG and APC assignment.
• Assigns modifiers as appropriate for CMS/CCI/LCD edits and adheres to AHA Coding Clinic and AMA guidelines.
• Tracks issues (e.g., missing documentation or charges) requiring follow-up to facilitate timely coding.
• Escalates identified concerns to appropriate leadership for resolution.
• Maintains up-to-date knowledge of changes in coding guidelines and regulations.
• Participates in educational opportunities to enhance knowledge in coding and reimbursement systems.
• Performs other duties as assigned by leadership.

• High school diploma or GED and 2 years of ICD-10 coding experience required; hospital-based coding experience strongly preferred.
• Associate's degree in Health Information Technology or a related field preferred.
• RHIA, RHIT, CCS, or CPC Certification required; or must obtain within 12 months of hire.
• Must possess a comprehensive knowledge of medical terminology, anatomy and physiology, and diagnostic and procedural coding.
• Experience utilizing encoding/grouping software preferred; ability to use ICD-10-CM/PCS and CPT-4 coding classifications (manual and automated) preferred.
• Ability to understand prospective payment systems, APC assignment, third-party payer requirements, NCCI, and other code editors.
• Proficiency with standard desktop and Windows-based systems, email, internet, and computer navigation; ability to use other software as required.
• Ability to work with minimal supervision, exercise independent judgment, and prioritize workload; strong analytical and communication skills; ability to handle multiple tasks in a potentially stressful environment.

Note: This role requires maintaining patient privacy and complying with applicable regulations.

Work whereevery moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.__ Position Summary: The Denial Specialist 2 is responsible for reviewing, analyzing, and appealing denials related to DRG (Diagnostic Related Group) validation denials. This role involves validating the coding and clinical accuracy, ensuring proper documentation, and collaborating with other departments to address payer concerns. Key responsibilities include timely investigation of DRG downgrades, submitting appeals, coordinating follow-up actions, and ensuring compliance with regulatory standards. The specialist also plays a critical role in preventing future downgrades by identifying trends and providing feedback to improve coding and clinical documentation practices. Position Responsibilities: Key Areas of Responsibility Denial Resolution · Review DRG validation denials from payers, analyze the denial reasons, and determine the appropriateness of the initial coding and clinical documentation. · Conduct a thorough review of medical records, coding, and clinical documentation to validate or appeal payer denials. · Prepare, document, and submit appeals for DRG denials, ensuring appeals are well-supported with clinical evidence, coding guidelines, and regulatory requirements. · Create detailed appeal letters that clearly outline the rationale for overturning the denial, referencing official coding guidelines (ICD-10-CM/PCS), payer policies, and clinical standards. · Work closely with the Clinical Documentation Improvement (CDI) and Coding teams to ensure accurate DRG assignment and enhance documentation practices that support appropriate reimbursement. · Collaborate with coding staff to identify and resolve complex DRG denial cases and improve coding accuracy. · Track and analyze DRG denial trends to identify common causes of denials. Provide feedback to the coding and CDI teams to prevent future denials and implement corrective actions. · Ensure that all DRG denial and appeal activities comply with federal, state, and payer-specific regulations, including maintaining knowledge of ICD-10-CM/PCS coding guidelines and CMS regulations. · Maintain accurate records of denial appeals in the designated software, including the status of appeals, timelines, and outcomes. · Monitor appeal deadlines to ensure timely submission of all required documentation and compliance with payer appeal windows. · Play an active role in optimizing DRG assignments by ensuring that clinical documentation and coding accurately reflect the severity of illness, complexity, and resource utilization. · Contribute to revenue protection efforts by successfully overturning inappropriate denials and reducing the financial impact of DRG downgrades. · Meet departmental performance goals, including Key Performance Indicators (KPIs) related to denial turnaround times, appeal success rates, and denial reduction targets. Denials Prevention · Analyze denial patterns to identify root causes and collaborate on preventive strategies. · Proactively address discrepancies between payer policies, regulatory standards and internal processes to prevent future denials. · Conduct regular audits of clinical documentation to ensure it supports coding and billing practices and meets payer requirements. · Ensure that proper documentation is collected and maintained to avoid potential denials or incomplete information. · Develop and implement process improvements aimed at preventing denials, such as better workflows, enhanced communication between departments, or technology solutions. · Provide regular reports and feedback to leadership and relevant departments on denial prevention efforts, identifying areas needing attention. Education · Provide ongoing education to the coding and CDI teams regarding DRG validation, payer guidelines, and best practices to minimize future denials. · Stays current on payer policies, regulatory changes, coding guidelines (e.g., ICD-10, DRG), and healthcare regulations that could impact denials and coding practices. Communication · Collaborate with Revenue Cycle, Billing, and Medical Staff teams to ensure a unified approach to denial management and appeals. · Serve as the primary contact with payers on DRG-related denials. Effectively communicate the clinical and coding rationale for the DRG assignment and challenge inappropriate denials. · Respond to department inquiries regarding claim denials, explaining the resolution process and providing updates as needed. · Communicates across departments as needed. Other · Performs other related duties as required. · Mentors new and existing team members. · Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Working Relationship: This Job Reports To (Job Title):HIM Manager Coding Quality and Education Education · Minimum: Associate degree or equivalent · Preferred: Bachelor’s degree or equivalent Experience · Minimum: Two (2) years of progressive on-the-job inpatient and/or clinical documentation experiencewithin healthcare revenue cycle or other healthcare field. · Preferred:Three (3) years of progressive on-the-job experience with DRG denial management and appeals preferred. Licensure, Certification, Registration · A Certified Professional Coder with a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS),and/or Certified Clinical Documentation Specialist (CCDS), Certified Documentation Integrity Practitioner (CDIP) Language Skills · Strong written and verbal communication skills. Knowledge, Skills and Ability Requirements: · Strong understanding of ICD-10-CM/PCS coding, DRG assignment, and payer regulations related to DRG validation. · Ability to analyze medical records, coding documentation, and payer denial reasons to determine appropriate appeal strategies. · Excellent written and verbal communication skills, with the ability to clearly articulate clinical and coding justifications in appeal letters. · Ability to manage multiple denials, prioritize tasks, and ensure timely submission of appeals. · Experience with electronic health record (EHR) systems, coding software, and denial tracking tools. · Proficient in tracking systems and data management tools. · Strong organizational skills with a high level of accuracy and attention to detail. · Strong interpersonal skills.** · Excellent communication and collaboration abilities. · Strong problem-solving, analytical, and critical thinking skills.** · Experience working with cross-functional departments to research and resolve issues using innovative solutions.** · Ability to work independently.** · Ability to provide outstanding customer service.*** * We take great care of careers. **__ With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. * * Job: *Coding and Billing Organization: *Hartford HealthCare Corp. Title: Denials Specialist 2 / HIM Coding Location: Connecticut-Farmington-9 Farm Springs Rd Farmington (10566) Requisition ID:

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: pride in what we do, knowing every moment matters here. We invite you to become part of Connecticuts most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.

Reviews and validates outpatient clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting, research, regulatory compliance and reimbursement.

Hematology/Oncology Infusion Coding experience is required for this position.

CHONC certification preferred

Position Responsibilities:

Key Areas of Responsibility

Coding

1. Applies knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.

2. Analyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD-10-CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.

3. Enters charges for procedures that are not soft coded as instructed for certain patient types.

4. Adheres to all department coding/charging procedures, policies, guidelines and quality standards.

5. Complete on a daily basis cases that have been assigned to them utilizing the appropriate work lists.

6. Complexity of skills includes but is not limited to the following:

Interventional radiology

Interventional cardiology

Endovascular

7. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association

Issue Resolution

1. Review claim edits and revise coding/charging as appropriate for specific range of ICD-10-CM/CPT/HCPCS codes.

2. Review accounts returned from various departments and process corrections for clean claim submission or post claim denial review for appeal.

3. Meet revenue cycle goals (Key Performance Indicators (KPIs) and Productivity Standards)

Communication

1. Seeks clarification from physicians or other staff in cases where documentation is absent, ambiguous, or contradictory.

2. Makes corrections based on collaboration with clinician or designee.

Training/Leadership

1. If required, trains new coders to become acclimated to the environment, and understanding internal coding policies and procedures and documentation guidelines.

2. Trains and mentors coders who wish to progress to more specialize coding of the most complicated types of accounts.

3. Advances the team by influencing desired H3W Leadership Behaviors

4. Supports and participates in special projects and assignments.

Education

Associates Degree or equivalent experience

Experience

Minimum: Two to four years of progressive on-the-job experience in an acute care hospital or physician.

Preferred: Four years or more of progressive on-the-job experience in an acute care hospital or physician office.

Licensure, Certification, Registration

Minimum: CPC, CPCH, or CCS certification required and maintained thereafter.

Preferred: CPC, CPCH, or CCS certification required and maintained thereafter.

Certified Interventional Radiology Cardiovascular Coder (CIRCC) certification

Knowledge, Skills and Ability Requirements:

Knowledge of:

ICD-10-CM diagnostic and CPT/HCPCS procedure codes

Working knowledge of clinical information

Microsoft Office Products; Word, Excel

Encoder and/or CAC

Skills:

Read, write and speak English proficiently.

Solid analytical capabilities.

Good organizational skills.

Proficiently read and interpret physician writing.

Ability to:

Function independently.

Handle multiple priorities.

Listen and acknowledge ideas and expressions of others attentively.

Converse clearly using appropriate verbal and body language.

Collaborate with others to achieve a common goal through mutual cooperation.

Influence others for positive and productive outcomes.

Utilize coding subject matter expertise to support new specialized coders and other projects.

Ability to work across the Hartford HealthCare System.

We take great care of careers. With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge helping to bring new technologies, breakthrough treatments and community education to countless men, women and children.

We know that a thriving organization starts with thriving employees--we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Job Title: HIM Coding Specialist
Department: RAD-O-RBO Coding
Location: Centre Square West Tower- 1500 Market Street
Hours: Full Time

Summary:

• Performs coding and abstracting for Penn Medicine Radiology inpatient and outpatient services by selecting the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures accurately to produce the highest level of reimbursement to which the facility and providers are legally entitled according to appropriate coding and compliance guidelines. Reviews and acts as a gatekeeper for the provider query process by being the primary point of contact for the Radiology provider community. Works with the Coding and Compliance Manager to review reports to ensure quality and performance standards are being met.

• Examines the complete medical record to accurately determine and sequence the principal & secondary diagnoses, procedures, complications, and co-morbidities demonstrating 96% accuracy as determined by audits. Accuracy is important due to the far-reaching impact on reimbursement and quality metrics.
• Simultaneously abstract and enter all information into the Epic system to ensure timely billing. This includes coding advanced Interventional Radiology services and biopsy procedures.
• Monitors assignments of ICD-10CM and CPT-4 coding to ensure full compliance with all billing requirements in accordance with federal and state regulations and specific contracts.
• Demonstrate a consistent level of performance; strive to maintain a steady level of productivity according to current department guidelines. An average of 40 records are coded daily.
• Possess the ability to code all facilities while maintaining the accuracy and productivity standards set above.
• Act as a Coding Quality Specialist by referring charts that require clarification of vague or unclear documentation for accurate coding to the physician for the needed documentation.
• Reviews and processes provider queries. This includes working with the coding staff to appropriately write the query as well as communicating with the provider community to ensure the query is answered.
• Cooperates with departmental work volumes by adjusting work schedules. Completes all assignments as directed by management in a conscientious and reliable manner. Meets established deadlines. Is willing to adjust the schedule to complete workload to meet pivotal revenue cycle deadlines when requested by management. Cooperates with departmental work volumes by adjusting work schedules.
• Consistently codes the oldest cases first and prioritizes high dollar cases over 4 days old first.
• Responsible for continuing education inside and outside the organization and tracking Continuing Education credits to maintain professional credentials. Regularly reviews coding literature keeps current on new revised coding guidelines, and shares information with colleagues. Reviews all coding clinic guidelines, coding literature, etc. Proactively shares information and trends with others.
• Performs revenue cycle activities as needed.
• Performs duties in accordance with Penn Medicine and entity values, policies, and procedures
• Other duties as assigned to support the unit, department, entity, and health system organization

• Certified Coding Specialist - CCS (AHIMA) or CPC (AAPC)
  
• RHIT or RHIA (preferred)
  

• H.S. Diploma/GED (Required)
• 2+ years' experience coding inpatient and outpatient medical records.
• Bachelor of Arts or Science (preferred)
• Health Information Management or Nursing (BSN) (preferred)

Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. JOB SUMMARY and RESPONSIBILITIES: Auditing * Validates International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10-CM) diagnoses and ICD-10-PCS (Procedural Classification System) or Current Procedural Terminology(CPT) codes and resulting DRGs/APCs to ensure consistency and efficiency in claims processing, data collection, and quality reporting for HHC * Validates Home Health Coding/OASIS reviews. * Prepares written reports on the results of the audits, including recommendations for improvement and compliance with state and federal laws, regulations and policy. * Presents audit reports, results and action plans to coding management for discussion and plan for dissemination to coders. * Presents quarterly Key Performance Indicators (KPI) to compliance office * Responsible for managing CHIME (Connecticut Health Information and Management Exchange) and Premier system edits * Utilize Cobius Institutional Audit Manager (IAM) software to streamline audits, communicate findings, and simplify reports. Education/Training * Provides feedback and creates focused educational/training programs on the results of auditing and monitoring activities for coders, CDS and providers as appropriate * Provides Coder, CDS staff and provider education on changes in regulations related to coding. * Provides coding feedback on complex cases. Communication * Insures the appropriate dissemination and communication of all regulation, policy, and guideline changes (eg. Code updates, coding guidelines, Local Coverage Determinations (LCD), Transmittals) to affected personnel. * Maintains system folders with coding policies, procedures, educational articles and coding compliance materials. Other * Participates in the development and review of HIM Coding Policy and Procedures. * Participates in general or special assignments and other duties as assigned * Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines This position reports to Manager Hospital HIM Coding Quality and Education Education: Associates Degree or equivalent experience Experience * Four or more years of progressive on-the-job coding experience in an acute care hospital. Licensure, Certification, Registration * CCS or CPC certification * For Home Health Hospice: * Home Health Coding Specialist – Diagnosis (HCS-D) and/or Home Care Coding Specialist – Hospice (HCS-H) * Home Health Clinical Specialist - OASIS (HCS-O) or OASIS Specialist – Certified (COS-C) Language Skills * Strong written and verbal communication skills. * Solid analytical capabilities. * Good organizational skills. * Critical thinking, problem solving and deductive reasoning skills. Knowledge, Skills and Ability Requirements: Knowledge of: * Comprehensive understanding of ICD-10-CM diagnosis and ICD-10-PCS and/or CPT/HCPCS operative procedure codes * Understands the Uniform Hospital Discharge Data Set (UHDDS) * Understands MS-DRGs, APCs and/or Outpatient Code Edits (OCE) and Correct Coding Initiative (CCI) edits * IRF-PAI (IP Rehabilitation) * Home Health understands: o PDGM payment model o OASIS * Working knowledge of clinical information * Extensive knowledge of state, federal and Medicare regulations related to coding * Basic knowledge of the revenue cycle for the purpose of communicating corrective action recommendations * Microsoft Office Products; Word, Excel * Encoder and/or Computer Assistant Coding (CAC) * HROI and Cobius Ability to: * Function independently. * Handle multiple priorities. * Listen and acknowledge ideas and expressions of others attentively. * Converses clearly using appropriate verbal and body language. * Collaborate with others to achieve a common goal through mutual cooperation. * Influence others for positive and productive outcomes. We take great care of careers . With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment. Job: *Coding and Billing Organization: *Hartford HealthCare Corp. Title: Coding Quality & Edu Spec 1 / HIM Coding Location: Connecticut-Farmington-9 Farm Springs Rd Farmington (10566) Requisition ID: