Outpatient Coder

This is a fully remote position, open to applicants in United States.

📋 Description

• Assign suitable ICD-10 diagnosis codes and CPT/HCPCS procedure codes to patient encounters based on medical documentation, physician notes, and additional information.

• Complete coding promptly to adhere to billing deadlines.

• Assist in addressing incomplete or missing documentation to expedite the billing process.

• Communicate with healthcare providers to clarify coding inquiries and concerns.

• Perform corrections on claim edits and review denials related to coding errors.

• Identify trends in coding or documentation that may pose revenue risks and report them to management.

• Stay up-to-date with coding and documentation guidelines, compliance policies, annual coding updates, payer policies, and industry changes.

• Execute additional duties as assigned.

• Review ambulatory medical records for multi-specialty provider organizations to ensure billed codes are supported by clinical documentation.

• Translate medical record data into language that payers can utilize to process physician charges.

• Ensure coding is compliant with all coding guidelines.

• Report to the Director of Revenue Integrity as part of an emerging coding team within the billing and credentialing service.

⛳️ Requirements

• Knowledge of ICD-CM (current edition), CPT, HCPCS coding systems, and CCI edits.

• Familiarity with third-party payer requirements, as well as federal and state medical coding and billing guidelines and regulations.

• Understanding of current ICD-10-CM and CPT/HCPCS Official Guidelines for Coding and Reporting.

• Knowledge of medical records content and management.

• Working knowledge of EMR through experience or education.

• Proficiency in medical terminology.

• Awareness of health information and patient confidentiality laws and regulations.

• Proficient in Microsoft Office applications, including Excel, Word, and PowerPoint.

• Adaptability to changing end-user business needs.

• Strong interpersonal and communication skills coupled with professionalism.

• Ability and willingness to take ownership of work activities and complete them accurately, efficiently, and in a timely manner.

• Eagerness to learn new software and systems.

• Capability to identify problem causes and develop corrective and preventive measures.

• Resilience in challenging situations and ability to overcome obstacles.

• Must remain in a stationary position 50–75% of the time.

• High School Diploma or equivalent is required.

• CPC Certification is mandatory.

• 3–5 years of CPT/HCPCS outpatient coding experience is preferred, ideally in a multi-specialty facility.

• Previous experience with Epic is highly preferred.

• Familiarity with the MassHealth ACO program is desirable.

• Knowledge of Federally Qualified Health Centers is preferred.

• Experience with anti-racism initiatives and/or personal experience with racism is highly favored.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and continuing education.

• Supportive work environment with a focus on diversity and inclusion.