Memorial Health System

  • Outpatient Coder

    Job Locations US-IL-Springfield
    Support Services
    Position Type
  • Overview

    The Outpatient Healthcare Coding Specialist will assign appropriate ICD-9-CM, ICD-10-CM and CPT codes to outpatient encounters. The coder will apply the appropriate diagnostic and procedural codes to individual patient health information for data retrieval, analysis and claims processing.  All work is performed in accordance with the rules, regulations and coding conventions as established by the American Hospital Association (Coding Clinic), ICD9, ICD10, CMS, and Memorial Health System organizational/institutional coding guidelines.  Under the direction of the Coding Manager, the Healthcare Coding Specialist will perform all tasks and duties in accordance with established standards, policies, procedures, protocols, and guidelines.



    High school diploma required. Associate Degree or some post-secondary education desired. 



    • Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required. Certification must be current.


    • Requires a minimum of one year demonstrated successful outpatient hospital coding experience in abstracting and coding information from patient records using ICD-9-CM, ICD-10-CM and CPT-4.
    • Minimum typing skill of 40 WPM and/or 1 year CRT experience required.

    Other Knowledge/Skills/Abilities:

    • Demonstrates excellent knowledge of proper use of ICD-9-CM, ICD-10-CM and CPT-4 coding guidelines, principles, AHA Coding Clinics and CPT Assistant.
    • Knowledgeable of Admission, Utilization Review, Billing and Collection process.
    • Demonstrates comprehensive knowledge of Medicare APC reimbursement.
    • Demonstrates excellent interpersonal and communication skills.
    • Demonstrates ability to work independently.
    • Word processing/computer application experience and knowledge desired. Coding software familiarity required.


    1. Review medical records and accurately code the principal and all secondary diagnoses and procedures using ICD-9-CM, ICD-10-CM and/or CPT coding conventions; sequence the diagnoses and procedures using coding guidelines; abstract and compile data from medical records to assign the most appropriate codes for optimal reimbursement.
    2. Coding of Outpatient Diagnostic, Outpatient Surgical, and Emergency Department Accounts- as assigned performs coding analysis on all accounts utilizing 3M and/or other coding products. Abstracts all coded accounts in coding system per procedure.  Ensure an APC assignment is accurate.
    3. Participates in required continuing education and compliance training programs to maintain an understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques to support the effective application of ICD-9-CM, ICD-10-CM and CPT coding guidelines for outpatient diagnoses and procedures. Staff will maintain up-to-date knowledge of medical records practices, standards, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Centers for Medicare and Medicaid (CMS), Federal Intermediary (FI) and other related organizations.
    4. Ensures compliance with all current Memorial Medical Center and department policies and procedures.
    5. Communicates with patient financial services to resolve billing/coding matters. Demonstrates ability to cooperate with Memorial Medical Center management personnel, physicians and other persons contacted during the working day.  Works directly with physician and Allied Medical Staff to clarify coding issues.  Utilizes physician documentation query form effectively.
    6. Enter and retrieve patient medical data from computer terminal updating entries as necessary; audit medical record for accuracy and completeness, note deficiencies and refer for appropriate follow up and completion.
    7. Assist with the training of employees in the use of coding manuals; review difficult classification situations and determine the most appropriate codes.
    8. Participates in monthly coding meeting with Coding Supervisors, and other meetings as determined appropriate
    9. Serve as a member of designated divisional committees and other steering committees as appropriate.
    10. Promotes MHS Guest Relations philosophy, Statement of Values, and follows MHS Behavior Standards and Code of Conduct. 
    11. Performs other related work as required or requested.  

    The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job.  Incumbents may be requested to perform tasks other than those specifically presented in this description.






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