Job Description
We are seeking a detail-oriented and experienced Outpatient Medical Coder with strong knowledge of the healthcare revenue cycle to join our team. The ideal candidate will be responsible for accurately coding outpatient medical records, ensuring compliance with coding guidelines, and supporting optimal reimbursement through effective revenue cycle processes.
Key Responsibilities:
• Assign accurate CPT, HCPCS, and ICD-10-CM codes to outpatient encounters (e.g., same-day surgery, ED visits, clinic visits, diagnostic procedures) based on medical record documentation.
• Review provider documentation to ensure it supports assigned codes and meets payer and regulatory requirements.
• Work closely with providers and clinical staff to clarify diagnoses and procedures when documentation is incomplete or unclear.
• Collaborate with the billing and revenue cycle team to resolve coding-related denials, rejections, and underpayments.
• Apply knowledge of payer guidelines, LCDs/NCDs, and medical necessity requirements.
• Monitor and follow up on coding edits, ensuring timely resolution to maintain revenue flow.
• Maintain up-to-date knowledge of coding guidelines, regulatory changes, and industry best practices.
• Participate in audits, quality reviews, and compliance initiatives to improve accuracy and efficiency.
Qualifications:
• Certification: CPC, COC, CCS, or equivalent coding credential required.
• Experience: Minimum 3 years of outpatient coding experience, with at least 1–2 years in revenue cycle operations (denial management, AR follow-up, charge capture, etc.).
• Strong knowledge of ICD-10-CM, CPT, HCPCS, and outpatient reimbursement methodologies (APCs, OPPS).
• Familiarity with E/M guidelines and outpatient facility/physician coding.
• Experience working in electronic health record (EHR) systems and coding software.
• Strong analytical, problem-solving, and communication skills.
• Ability to work independently, meet productivity and accuracy standards, and manage multiple priorities in a remote setting.
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