Coder 3 Outpatient

Job ID
Employment Type
Full Time
HIM Coding
Hours / Pay Period
Saint Marys Medical Center
Standard Hours
Monday - Friday (8:00am - 5:00)
Work Schedule
8 Hour


St. Mary’s Medical Center has been caring for the health of San Franciscans since 1857 when it was founded by eight Sisters of Mercy from Ireland. It is an accredited, not-for-profit hospital, located across the street from Golden Gate Park. It is a full-service acute care facility with more than 575 physicians and 1,100 employees who provide high-quality and affordable health care services to the Bay Area community.Home to advanced medical practices, such as the nation’s first digital cardiac catheterization laboratory, innovating orthopedic and spine surgery and comprehensive rehabilitation, and a state-of-the-art cancer center. St. Mary’s Medical Center is one of San Francisco’s leading hospitals, offering patients a full range of outpatient and inpatient services delivered with the human touch. Strategies and business development are centered on Oncology Services, Cardiac Services, and Orthopedics.


Job Summary:


This position is an on-site position, remote work option is not available.

The Coder III is a member of the Health Information Management Team responsible for ensuring the accuracy and completeness of clinical coding, validating the information in the databases for outcome management and specialty registries, across the entire integrated healthcare system. The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health information records for data retrieval, analysis and claims processing. This position is expected to perform duties in alignment with the mission and policies within the Dignity Health organization, TJC, CMS, and other regulatory agencies.

  • Assign codes for diagnoses, treatments, and procedures according to the appropriate classification system for Same Day Surgery, Wound Care, IVR, CIVR (specialty), Observation admissions following official coding guidelines.
  • Can also code ancillary and/or emergency department charts if needed.
  • Review provider documentation to determine the reason for the visit, first listed and secondary diagnosis and surgical procedures.
  • Provide documentation feedback to providers, as needed, and queries physicians when appropriate.
  • Utilize technical coding principals and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses, ICD-10-PCS as appropriate, and CPT-4 for procedures.
  • Ensure accurate coding by clarifying diagnosis and procedural information through an established query process if necessary.
  • Extract required information from source documentation and enter into encoder and abstracting system.
  • Review documentation to verify and when necessary, correct the patient disposition upon discharge.
  • Prioritize work to ensure the timeframe of medical record coding meets KPl's.
  • Serve as a resource for coding related questions as appropriate.
  • Meet performance and quality standards at the Coder II level.
  • Abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines.
  • Assists with OSHPD correction.
  • Participate in department meetings and educational events.
  • Other duties as assigned that have a direct impact on our ability to decrease the DNFB and support Revenue Cycle, including but not limited to charge validation, observation calculations, etc..


Minimum Qualifications:

  • High School Diploma or equivalent.
  • Completion of an AHIMA or AAPC accredited coding certification program that includes courses that are critical to coding success such as Anatomy and physiology, pathophysiology, pharmacology, Anatomy I Physiology, Medical Terminology, and ICD-10 and CPT coding courses, etc..
  • Have and maintain current coding credential from AHIMA or AAPC (RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H ).
  • Two years of coding and abstracting experience or an equivalent combination of education and experience required.
  • A minimum of 2 years of Outpatient medical coding experience (Same Day, Wound Ce, IVR, CVICR, Observation, etc.).*
  • Must have ICD-10 coding experience.
  • Ability to use a PC in a Windows environment, including MS Word and EMR systems
  • Ability to pass coding technical assessment.

*One year of experience will be waived for those who have attended the Dignity Health Coding Apprenticeship Program.


Preferred Qualifications:

  • Experience with various Encoder systems (i.e., OptumCAC, Cemer).
  • Intermediate level of Microsoft Excel.
  • Experience with coding and charge validation.

This position is an on-site position, remote work option is not available.


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