Outpatient Coder-Remote

Reviews and assigns appropriate ICD-10-CM, CPT, and HCPCS codes for outpatient records, ensuring compliance with coding and billing regulations.

Codes a variety of outpatient encounters, including observation stays, outpatient surgeries, interventional radiology, cardiac catheterization, emergency department visits, wound care, and ancillary services.

Applies correct coding guidelines and payer-specific policies, ensuring adherence to LCD/NCD (Local Coverage Determination/National Coverage Determination) requirements.

Resolves coding edits and denials, identifying and correcting discrepancies while maintaining compliance with corporate and regulatory standards.

Maintains coding productivity and accuracy standards, achieving a 95% coding accuracy rate and meeting corporate benchmarks.

Consults with the Manager or other subject matter experts to resolve complex coding issues and discrepancies.

Collaborates with Clinical Documentation Integrity (CDI) specialists and billing teams, ensuring complete and accurate coding and documentation.

Ensures adherence to HIPAA privacy and security standards, maintaining confidentiality of patient records.

Utilizes hospital coding software and related tools to ensure accuracy and compliance with corporate policies.

Performs other duties as assigned.

Maintains regular and reliable attendance.

Complies with all policies and standards.

H.S. Diploma or GED required

Associate Degree in Health Information Management, Medical Coding, or a related field preferred or

One (1) year coding certification in Health Information Management preferred

1-3 years of outpatient coding experience in an acute care hospital or healthcare system required

Experience coding emergency department visits, outpatient procedures, interventional radiology, and/or ambulatory surgery preferred

Strong knowledge of ICD-10-CM, CPT, and HCPCS coding principles and outpatient reimbursement methodologies.

Understanding of Local Coverage Determination (LCD), National Coverage Determination (NCD), and payer-specific coding guidelines.

Experience with electronic health record (EHR) systems and coding software (e.g., 3M, Meditech, Epic, Cerner).

Ability to analyze and resolve coding edits, rejections, and denials efficiently.

Strong attention to detail and organizational skills.

Excellent communication and problem-solving skills, with the ability to collaborate with CDI teams and billing departments.

Knowledge of HIPAA regulations and patient privacy standards.

Certified Coding Specialist (CCS) – AHIMA required or

CCA - Certified Coding Associate required or

Certified Outpatient Coder (COC) – AAPC required

RHIA - Registered Health Information Administrator preferred or

RHIT - Registered Health Information Technician preferred