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

📋 Description

• Evaluate outpatient coded cases for completeness and accuracy in coding.

• Identify potential opportunities for coding and APC/payment improvements.

• Research relevant guidelines to back recommended modifications.

• Timely communicate coding modifications to coders or quality reviewers.

• Offer expert coding guidance to coding teams and global quality reviewers.

• Convey necessary coding education topics to the Manager of Outpatient Coding Quality.

• Perform quality assessments of outpatient records and verify the accuracy of CPT®, HCPCS, ICD-10-CM, modifier, and APC code assignments.

• Provide feedback from audits, along with coaching and guidance.

• Analyze audit outcomes and recognize trends for educational purposes, process enhancements, and quality improvements.

• Collaborate with Quality, Education, Denials, and Coding Operations teams to address coding challenges and support revenue integrity initiatives.

• Keep abreast of industry regulations and coding guidelines.

• Foster continuous improvement through teamwork, training, and process optimization, while ensuring accuracy, productivity, and performance in a remote setting.

⛳️ Requirements

• High School diploma, GED, or equivalent qualification.

• One or more active certification(s) required: RHIT, RHIA, COC, CCS-P, or CCS.

• At least seven (7) years of experience in hospital outpatient coding, covering Ancillary, Emergency Department, Same Day Surgery, Observation, Wound Care, E/M Professional service, Interventional Cardiology, and Interventional Radiology.

• Bachelor's or Associate Degree preferred.

• Familiarity with CPT®, HCPCS, ICD-10-CM, modifier, and APC code assignments.

• Understanding of CMS, AHA, AMA, and other regulatory standards.