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Coder I - MPG - FT - Days - MSS - Remote Eligible

Memorial Healthcare System

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Location:
United States , Miramar

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Category:
IT - Administration

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

Memorial is seeking an experienced Medical Coder with a strong background in professional billing for Radiation Oncology services. The ideal candidate will have in-depth knowledge of CPT, ICD-10, and HCPCS coding, with proven expertise in radiation oncology coding guidelines, documentation requirements, and payer-specific billing practices. Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.

Job Responsibility:

  • Reviews medical record documentation
  • May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance
  • 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
  • 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
  • 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)
  • 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
  • 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
  • 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
  • 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

Requirements:

  • 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
  • Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work independently with minimal supervision
  • Must be able to work in a stressful environment and take appropriate action
  • 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

Additional Information:

Job Posted:
May 04, 2026

Employment Type:
Fulltime
Work Type:
Hybrid work
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