Coder III (Hospital Coding): Medical Coding

Primary Duties And Responsibilities

The Coder (Hospital Billing) reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM and ICD-10-PCS codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health information Management Association (AHIMA) and adheres to all official coding guidelines. 

Responsibilities

• Verifies that all ICD-10-CM and ICD-10-PCS codes are correctly captured. Verifies that physician and other key information is correctly abstracted. 
• Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality accuracy rate of 95% or better.
• Coder III assigns codes for diagnoses, treatment, and procedures for inpatient surgeries. Determines the correct principal diagnosis, co-morbidities, complications, secondary conditions, and surgical procedures.  
• Abstracts correctly all required information from record including the correct discharge disposition and HCAI required information.  
• Assigns correct MS-DRG and APR-DRG and correct Present on Admission (POA) indicators and identifies (HAC) Hospital Acquired Conditions. 
• Queries physicians per established policy and procedure when documentation is not clear or conflicting. 
• Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services.  Participates in internal and external quality review meetings. Has strong interpersonal skills and is able to work effectively with members of the coding and Clinical Documentation Improvement (CDI) teams. 
• Performs other duties as assigned.

Qualifications

Education and Experience

High school diploma or equivalent required.

Medical Coding - Hoag Hospital:

• Completion of a certified coding program or graduate of a CAHIM accredited HIT program required.
• Five years of progressive inpatient coding experience in an acute care facility.

Preferred:

• Adept coding experience (ICD-10-CM/ICD-10-PCS) in multiple specialties to include but are not limited to: OB/GYN, Urology, Oncology, Pain Management, Cardiology, Neurology, and Orthopedics. Knowledge of the elements of disease processes and related procedures. Strong clinical knowledge and understanding of pathology / physiology of disease processes.

• Experience working in EPIC- EMR.

License Required

N/A

License Preferred 

N/A

Certifications Required 

Medical Coding - Hoag Hospital: Certified Coding Specialist (CCS)

Certifications Preferred 

Coding - Hoag Clinic: Certified Urology Coder (CUC)

Hoag Memorial Hospital Presbyterian is a nonprofit regional health care delivery network in Orange County, California, consisting of three acute-care hospitals with sixteen urgent care centers, eleven health centers and a network of more than1,800 physicians, 100 allied health members, 8,000 employees, and 2,000 volunteers. More than 30,000 inpatients and 550,000 outpatients choose Hoag each year.

For over 70 years, Hoag has delivered a level of personalized care that is unsurpassed among Orange County’s health care providers. Since 1952, Hoag has served the local communities and continues its mission to provide the highest quality health care services through the core strategies of quality and service, people, physician partnerships, strategic growth, financial stewardship, community benefit and philanthropy.

Hoag offers a comprehensive blend of health care services including six institutes providing specialized care in the areas of cancer, heart and vascular, neurosciences, women's health, orthopedics, and digestive health through our institutes.

Hoag was the highest ranked hospital in Orange County in the 2024-2025 U.S. News &World Report, the only Orange County hospital ranked in the top 10 for California. The organization was ranked the #5 hospital in the Los Angeles Metro Area and the #10 hospital in California.

To learn more about Hoag’s awards and accreditations, visit: https://www.hoag.org/about-hoag/awards-accreditations/.

Hoag is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. Hoag is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. Hoag hires a diverse group of people in a manner that allows them to reach their full potential in the pursuit of organizational objectives.