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Hospital Inpatient Coder Certified – FT – Day – HIM Facility Coding
HCA Healthcare. Review and analyze inpatient medical record documentation .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in ICD-10-CM and ICD-10-PCS coding, ensuring compliance with Official Coding Guidelines and CMS regulations. Proficient in medical record documentation analysis, coding accuracy, and collaboration with Clinical Documentation Improvement teams.
Highest-signal resume keywords
Certified Coding Specialist (CCS)ICD-10-CM CodingICD-10-PCS CodingMedical Record Documentation AnalysisEncoder and EMR Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
ICD-10-CM Diagnosis CodingICD-10-PCS Procedure CodingMS-DRG/APR-DRG GroupingMedical Terminology KnowledgeAttention to DetailCoding ComplianceCoding Audits ParticipationDocumentation Improvement IdentificationCoding Accuracy StandardsProductivity Standards
Soft Skills
Organizational SkillsInterpersonal SkillsVerbal Communication SkillsWritten Communication SkillsTime Management
Tools & Technologies
EncoderElectronic Medical Record (EMR)
Certifications & Qualifications
Certified Coding Specialist (CCS)Registered Health Information Technician (RHIT)Registered Health Information Administrator (RHIA)
Industry Keywords
Inpatient CodingOfficial Coding GuidelinesUHDDS DefinitionsCoding Clinic GuidanceCMS RegulationsMCC/CCPOA IndicatorsHACsPSIsSOI
About the role
Key responsibilities & impact- Review and analyze inpatient medical record documentation
- Assign accurate and compliant ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes
- Assign and properly sequence codes according to Official Coding Guidelines, UHDDS definitions, Coding Clinic guidance, and CMS
- Assign correct MS-DRG/APR-DRG groupings
- Capture MCC/CC, POA indicators, HACs, PSIs, SOI, and ROM accurately
- Issue compliant physician queries for incomplete, ambiguous, or inconsistent documentation
- Identify documentation gaps and escalate when clarification is needed
- Resolve coding edits, queries, and discrepancies
- Participate in internal and external audits and corrective action plans
- Collaborate with Clinical Documentation Improvement (CDI) teams
- Identify documentation improvement opportunities and workflow challenges
- Meet or exceed accuracy and productivity standards
- Code inpatient encounters efficiently to support timely billing and reduce DNFB
- Review accounts held for coding-related issues
- Maintain coding credentials and stay current with ICD-10-CM/PCS, DRG, and regulatory updates
- Participate in continuing education, team meetings, and training sessions
- Perform other duties as assigned
Requirements
What you’ll need- High school diploma or equivalent
- Certified Coding Specialist (CCS) certification required
- Previous hospital coding experience
- Excellent organizational, interpersonal, verbal, and written communication skills
- Keen attention to detail and vigilance
- Proper phone and email etiquette
- Excellent time management to meet deadlines and productivity targets
- Intermediate computer skills
- Thorough knowledge of medical terminology, anatomy, and physiology
- Understanding of ICD-10-CM and ICD-10-PCS
- Knowledge and experience using an encoder and EMR required
- Ability to work independently in a remote environment
- Ability to work under pressure and in a fast-paced environment
- Ability to meet quality and productivity standards
- Ability to interact effectively with other staff members
- Must maintain required coding credentials (CCS, RHIT, RHIA)
- Candidates must be located in New Jersey, Pennsylvania, or Alabama
Benefits
Comp & perks- Medical Plan
- Prescription drug coverage & In-House Employee Pharmacy
- Dental Plan
- Vision Plan
- Flexible Spending Account (FSA), including Healthcare FSA and Dependent Care FSA
- Retirement Savings and Investment Plan
- Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
- Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
- Long Term Disability (LTD)
- Short Term Disability (STD)
- Employee Assistance Program
- Commuter Transit
- Commuter Parking
- Supplemental Life Insurance, including Voluntary Life Spouse, Employee, and Child coverage
- Voluntary Legal Services
- Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
- Voluntary Identity Theft Insurance
- Voluntary Pet Insurance
- Paid Time-Off Program
- Remote work arrangement