Medical Coder-Outpatient

Job Summary

Medical Coder-Outpatient is responsible for reviewing and coding outpatient medical records and documentation for healthcare services rendered. This role ensures that all diagnoses, procedures, and services provided in an outpatient setting are accurately coded using standardized coding systems (ICD-10, CPT, HCPCS). The coder will ensure compliance with insurance requirements, governmental regulations, and industry standards to facilitate correct reimbursement and support the accurate billing process.

Education & Experience

• High school diploma/GED
• Certifications, Licenses, Or Registration Required: N/A
• PREFERRED Qualifications: Associate's degree in health information management or medical coding and experience in medical coding or healthcare billing. Preferred One of the following medical coding certifications from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) is preferred post-hire within one (1) year: Registered Health Information Management Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Coding Specialist- Physician-Based (CCS-P), Certified Professional Coder (CPC or CPC-A). Any Physician specialty certification from AAPC

Knowledge, Skills & Abilities

• Knowledge of electronic coding systems
• Proficiency in ICD-10, CPT, and HCPCS coding systems; strong knowledge of outpatient healthcare services and procedures
• High level of accuracy and attention to detail in reviewing medical records and assigning correct codes
• Strong verbal and written communication skills to collaborate with healthcare professionals, insurance providers, and internal departments
• Proficiency in electronic health record (EHR) systems and coding software

Responsibilities

• Review outpatient medical records to assign appropriate ICD-10, CPT, and HCPCS codes
• Ensure coding accuracy and compliance with regulations, payer policies, and guidelines
• Work with billing teams to prepare and submit claims, resolving any coding-related denials
• Collaborate with healthcare providers to clarify documentation and ensure proper code assignment
• Stay current on coding updates and payer requirements
• Demonstrative effective communication and response using systems available to both the Hospital Coder and management through telephone and email communication
• Demonstrate effective use of required software

Environmental And Physical Demands

• No exposure to unpleasant or disagreeable physical environment such as high noise level and exposure to heat and cold
• No handling or working with potentially dangerous equipment
• Occasional working hours beyond regularly scheduled hours
• Occasional travelling to offsite locations
• Frequent activities subject to significant volume changes of a seasonal/clinical nature
• Constant work produced is subject to precise measures of quantity and quality
• Occasional bending
• Occasional lifting/carrying up to 10 pounds
• Occasional lifting/carrying up to 25 pounds
• No lifting/carrying up to 50 pounds
• No lifting/carrying up to 75 pounds
• No lifting/carrying up to100 pounds
• No lifting/carrying 100 pounds or more
• Occasional climbing
• No crawling
• Occasional crouching/stooping
• Occasional driving
• No kneeling
• Occasional pushing/pulling
• Frequent reaching
• Frequent sitting
• Frequent standing
• Occasional twisting
• Frequent walking