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Medical Coder III - HIM Hospital OP

This job posting is no longer active.

Job ID: 8289
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job

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Job Description


Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.

**Position is Virtual/Remote**


Performs technical and administrative work reviewing, abstracting and assigning accepted medical codes for outpatient (Hospital Billing – Health Information Management) diagnoses and procedures for ambulatory surgery and observation services. Duties are performed in compliance with third party, state and federal regulations according to standardized procedures. 

Description of Job Responsibilities:

  • Assigns International Classification of Diseases (ICD-10-CM) diagnosis codes in an accurate and productive manner.
  • Assigns all codes to chronic conditions documented that may impact Hierarchal Condition Categories (HCCs) or expected mortality.
  • Assigns Healthcare Common Procedure Coding System (HCPCS) and Current Procedural Terminology (CPT) codes in an accurate and productive manner.
  • Groups codes and completed product into payment groups. Analyzes information for optimal and proper reimbursement.
  • Reviews National Coverage Determination (NCD), Local Coverage Determination (LCD), and Correct Coding Initiative (CCI) edits and any other coding edits and applies changes to code assignments appropriately, and/or adds modifiers appropriately.
  • Recognizes and has knowledge of Medical Necessity requirements and resolves edits during code assignments.
  • Ensures compliance with all appropriate coding, billing and data collection regulations and procedures.
  • Provides information to physicians and other health care staff regarding current coding practices and changes in 3rd party, state and federal regulations and guidelines.
  • Reviews, analyzes and abstracts physician/other documentation for diagnoses and other services provided.
  • Obtains missing information and/or clarifies existing information.
  • Accepts feedback from Auditor as needed to avoid future errors.
  • Accepts feedback from PWC Smart reviews and makes edits as needed to avoid future errors.
  • Reviews and processes PWC SMART edits.
  • Researches appropriate databases for validation of information.
  • Utilizes a variety of software (e.g. Epic, Optum CAC, MS Office, etc.) to compile and validate medical information.
  • Exhibits effective organizational skills, time management, and management of multiple priorities. 
  • Effectively manage projects and effectively work with various levels of staff (including on-site and remote). 

Job Requirements:

  • High School diploma or GED
  • Successful completion of the UNC HCS Hospital OP Coder Proficiency Test.
  • Must have AHIMA (American Health Information Management Association) certification and credential or AAPC (American Academy of Professional Coders) certification and credential
  • Two (2) years of experience in hospital coding.
  • Strong knowledge of ICD-10-CM and HCPCS/CPT coding with analytical and data mining skills. 
  • Strong knowledge of Ambulatory Payment Classification (APC) system for outpatient cases. 
  • Must possess strong communication skills, both written and verbal and have extensive attention to detail. 
  • Ability to interpret complex medical conditions and work with complex coding applications. 
  • Ability to interpret federal and state regulations as they relate to coding and compliance.

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Diversity Statement

The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.

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