Medical Coding Specialist – Outpatient

This is a fully remote position, open to applicants in Illinois, +1 more state.

📋 Description

• Evaluate medical reports and documentation from physicians for outpatient services in clinics and hospitals.

• Utilize diagnostic and procedural codes for processing claims, data retrieval, and analysis of patient health information.

• Primarily focus on coding for the Emergency Department and Urgent Care while providing assistance in other areas as needed.

• Assign ICD and CPT codes for professional services and ambulatory outpatient facilities.

• Input professional codes for providers in the Emergency Room and Urgent Care settings.

• Conduct audits of electronic medical records to ensure accuracy of patient, insurance, diagnosis, and procedure codes.

• Review and resolve NCCI and OCE edits.

• Collaborate with clinical department directors and medical billing staff to clarify coding standards and rectify claim edits.

• Identify and communicate potential missed revenue opportunities to ambulatory departments.

• Partner with business analysts to establish new charge codes as necessary.

• Investigate denied insurance claims and appeal them in a timely manner.

• Extract relevant information from patient records utilizing the hospital information system.

• Query physicians for clarification on documentation or code assignments.

• Recognize coding issues or trends and engage Revenue Cycle leadership when necessary.

• Provide education on changes in coding practices.

• Participate in continuing education programs and review educational materials to stay updated and maintain coding recertification.

• Assist in the development of coding policies and procedures.

• Support the training of new employees and job shadowing initiatives.

• Undertake other related tasks as required.

⛳️ Requirements

• Must be a resident of Wisconsin or Illinois.

• Successful completion of a professional coding course recognized by AHIMA or AAPC and/or an associate degree in a healthcare-related field is required.

• No previous experience is necessary.

• Must obtain AHIMA or AAPC credentials within six months of hire and maintain them thereafter.

• Acceptable certifications include RHIT, RHIA, CCA, CCS, CPC-H, CPC, CIC, or COC.

• Proficiency in using ICD and CPT coding protocols.

• Ability to audit electronic medical records and address NCCI and OCE edits.

• Capability to clarify documentation and code assignments with physicians.

• Skill in investigating and appealing denied claims.

• Competence in abstracting information from patient records using a hospital information system.

• Ability to provide education on coding changes and engage in ongoing education and recertification.

🏝️ Benefits

• Competitive health and dental insurance options.

• Flexible paid time off to promote work-life balance.

• Retirement plan with immediate vesting and employer matching contributions.

• Discounted membership to our state-of-the-art fitness facility.

• Generous tuition reimbursement program.

• Employer-provided life and disability insurance.

• Free parking at the facility.