Medical Coder

Benefits:

• 401(k)
• 401(k) matching
• Company parties
• Dental insurance
• Health insurance
• Opportunity for advancement
• Paid time off
• Training & development
• Vision insurance

The ICD-10 Home Health & Hospice Medical Coder is responsible for accurately reviewing, analyzing, and assigning ICD-10-CM diagnosis codes to clinical documentation for home health and hospice services. This role ensures compliance with CMS guidelines, OASIS requirements, and agency policies to support precise reimbursement, high-quality patient care, and regulatory compliance. The ideal candidate has demonstrated experience in Home Health ICD-10 coding, strong knowledge of OASIS/Evaluation criteria, and a thorough understanding of PDGM (Patient-Driven Groupings Model).

Review clinical documentation to identify appropriate and accurate ICD-10-CM codes for home health and hospice encounters.

Assign primary and secondary diagnoses following CMS, PDGM, and regulatory requirements.

Validate medical necessity and ensure coding supports the plan of care and services rendered.

Review and interpret physician orders, clinical notes, OASIS assessments, and other documentation to ensure accurate code selection.

Ensure all coding aligns with CMS, industry, and agency standards, including PDGM/PEPPER guidelines.

Conduct self-audits or participate in agency coding audits to maintain accuracy and compliance.

Assist with corrections and updates based on audit findings or regulatory changes.

Maintain strict confidentiality and follow HIPAA requirements.

Communicate with clinicians, QA staff, and the billing department to clarify diagnoses, resolve documentation discrepancies, and improve coding accuracy.

Provide feedback to clinical staff regarding documentation gaps that impact coding or reimbursement.

Participate in training or educational sessions to enhance coding competency and knowledge of industry updates.

Complete coding assignments within established departmental timelines.

Ensure accurate and timely submission of coded encounters for billing and compliance.

Assist in optimizing coding workflows, documentation processes, and clinical data accuracy.

Minimum 2 years of Home Health ICD-10 coding experience (required).

Certification from a recognized credentialing body such as:

• HCS-D (Home Care Coding Specialist–Diagnosis) – preferred
• CPC, CCS, COC, or RHIT/RHIA accepted with Home Health-specific experience

Strong understanding of PDGM, OASIS documentation requirements, and Medicare regulations.

Experience with home health EMR systems (e.g., Homecare Homebase, Well Sky/Kinnser, Matrix Care).

Excellent analytical, critical-thinking, and documentation review skills.

Strong understanding of pathophysiology, medical terminology, and clinical documentation requirements.

Hospice coding experience (ICD-10-CM) strongly preferred.

Knowledge of HIS (Hospice Item Set) and hospice regulatory requirements.

Experience working remotely or in a high-volume coding environment.

Familiarity with PEPPER reports and quality metrics for home health agencies.