Augusta Health
Coder III
role at
Augusta Health
Overview
At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer a purpose-driven career in a nationally recognized, independent health system located in Virginia’s scenic Shenandoah Valley.
Job Summary
Under the direction of the Health Information Management Director and the Coding Manager, the
Coder III
follows all regulatory guidelines in the reporting and sequencing of ICD-10-CM and PCS codes for all patient accounts, generates coding queries to physicians to clarify patient condition(s) when conflicting or ambiguous information is reflected in the patient record, understands their role in quality performance measures, and serves as a resource to the Business Office in the reconciliation and resolution of problematic accounts. This position plays a critical role in supporting Augusta Health’s mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities.
Essential Job Duties
Accurately enter ABS data (e.g. Surgeon name, procedure date, discharge disposition, admit diagnosis, POA status, etc.)
Meets or exceeds bill drop dates/AR expectations
Accurately reports principal diagnosis in keeping with the most current AHA Coding Clinic and ICD-10-CM/ICD-10PCS guidelines.
Works with Coding Manager and Denial Management Coordinator to ensure all coding denials are addressed timely.
Generates appropriate query selection based on clinical evidence established in the patient medical record. Formats non-standardized queries in keeping with AHA Coding Clinic, CMS, and QIO guidelines. Utilizes standardized query templates when available.
Maintains established Productivity Standards: Inpatient encounters – average of 2 accounts per hour.
Meets or exceeds the expected DRG/APC accuracy rate of 95% (diagnosis and procedural codes applied to accounts result in the appropriate DRG or APC assignment).
Accurately reports procedure codes: All ICD-10-CM and CPT procedure codes are accurately coded and reported in keeping with AHA Coding Clinic, CPT Assistant, ICD-10-CM, CPT-4, and/or payer guidelines. 95%+ accuracy.
Accurately reports secondary diagnoses in keeping with the most current guidelines.
Required Qualifications
Education: High School Diploma or GED equivalent
Licensure/Certification: CCS or CPC
Experience: Inpatient Coder - minimum of three years hospital inpatient coding experience
Eligibility to work in the United States and meet Virginia state employment requirements
Preferred Qualifications
Education: Associate's Degree in Health Information Mgmt (HIM)
Licensure/Certification: CCS, RHIT, RHIA; CCA, COC, CIC, CPA-A
Experience: Three years inpatient coding experience; prior hospital/healthcare system experience
Competencies, Knowledge, Skills And Abilities
Strong written and oral communication; ability to effectively communicate with all hospital practitioners
Proficiency in computer applications, grouper software, Medicare edits, and coding/abstracting software
Comprehensive knowledge of anatomy, physiology, medical terminology, and disease processes
Analytical ability to interpret clinical data for appropriate code assignment
Proficiency in abstracting chart data into computer systems
Ability to work independently, attention to detail, and good critical thinking
High ethical standards due to confidential patient information
About Augusta Health
Augusta Health is an independent, nonprofit health system located in Fishersville, Virginia, offering inpatient and outpatient services, including Augusta Medical Center and Augusta Medical Group. Our commitment to excellence and compassionate care makes us a leading employer in the region.
Equal Opportunity Statement
Augusta Health recruits, hires, and promotes qualified candidates for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran or military discharge status, and family medical or genetic information. We foster a diverse and inclusive workplace in accordance with federal and Virginia state employment laws.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
#J-18808-Ljbffr
role at
Augusta Health
Overview
At Augusta Health, your work matters — and so do you. Whether you're delivering direct patient care, supporting operations, or innovating behind the scenes, every role contributes to our mission of promoting wellness and healing through compassionate service. We offer a purpose-driven career in a nationally recognized, independent health system located in Virginia’s scenic Shenandoah Valley.
Job Summary
Under the direction of the Health Information Management Director and the Coding Manager, the
Coder III
follows all regulatory guidelines in the reporting and sequencing of ICD-10-CM and PCS codes for all patient accounts, generates coding queries to physicians to clarify patient condition(s) when conflicting or ambiguous information is reflected in the patient record, understands their role in quality performance measures, and serves as a resource to the Business Office in the reconciliation and resolution of problematic accounts. This position plays a critical role in supporting Augusta Health’s mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities.
Essential Job Duties
Accurately enter ABS data (e.g. Surgeon name, procedure date, discharge disposition, admit diagnosis, POA status, etc.)
Meets or exceeds bill drop dates/AR expectations
Accurately reports principal diagnosis in keeping with the most current AHA Coding Clinic and ICD-10-CM/ICD-10PCS guidelines.
Works with Coding Manager and Denial Management Coordinator to ensure all coding denials are addressed timely.
Generates appropriate query selection based on clinical evidence established in the patient medical record. Formats non-standardized queries in keeping with AHA Coding Clinic, CMS, and QIO guidelines. Utilizes standardized query templates when available.
Maintains established Productivity Standards: Inpatient encounters – average of 2 accounts per hour.
Meets or exceeds the expected DRG/APC accuracy rate of 95% (diagnosis and procedural codes applied to accounts result in the appropriate DRG or APC assignment).
Accurately reports procedure codes: All ICD-10-CM and CPT procedure codes are accurately coded and reported in keeping with AHA Coding Clinic, CPT Assistant, ICD-10-CM, CPT-4, and/or payer guidelines. 95%+ accuracy.
Accurately reports secondary diagnoses in keeping with the most current guidelines.
Required Qualifications
Education: High School Diploma or GED equivalent
Licensure/Certification: CCS or CPC
Experience: Inpatient Coder - minimum of three years hospital inpatient coding experience
Eligibility to work in the United States and meet Virginia state employment requirements
Preferred Qualifications
Education: Associate's Degree in Health Information Mgmt (HIM)
Licensure/Certification: CCS, RHIT, RHIA; CCA, COC, CIC, CPA-A
Experience: Three years inpatient coding experience; prior hospital/healthcare system experience
Competencies, Knowledge, Skills And Abilities
Strong written and oral communication; ability to effectively communicate with all hospital practitioners
Proficiency in computer applications, grouper software, Medicare edits, and coding/abstracting software
Comprehensive knowledge of anatomy, physiology, medical terminology, and disease processes
Analytical ability to interpret clinical data for appropriate code assignment
Proficiency in abstracting chart data into computer systems
Ability to work independently, attention to detail, and good critical thinking
High ethical standards due to confidential patient information
About Augusta Health
Augusta Health is an independent, nonprofit health system located in Fishersville, Virginia, offering inpatient and outpatient services, including Augusta Medical Center and Augusta Medical Group. Our commitment to excellence and compassionate care makes us a leading employer in the region.
Equal Opportunity Statement
Augusta Health recruits, hires, and promotes qualified candidates for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran or military discharge status, and family medical or genetic information. We foster a diverse and inclusive workplace in accordance with federal and Virginia state employment laws.
Seniority level
Mid-Senior level
Employment type
Full-time
Job function
Health Care Provider
Industries
Hospitals and Health Care
#J-18808-Ljbffr