Outpatient Coder

About Our Client:Community Care Cooperative (C3) is a non-profit organization governed by Federally Qualified Health Centers (FQHCs). It operates as an FQHC-led accountable care organization (ACO), negotiating value-based payor contracts and managing compliance, financial, and population health functions to maximize incentives for FQHCs. It is the largest Medicaid ACO in Massachusetts and offers various business services nationwide. Additionally, it serves as a Management Services Organization (MSO) providing financial, operational, and technological services to groups of FQHCs, including EHR licensing, pharmacy consulting, billing, and credentialing. About the Opportunity:The OUTPATIENT CODER is responsible for reviewing ambulatory medical records for multi-specialty provider organizations to ensure billed codes accurately reflect clinical documentation and comply with coding guidelines. Reporting to the Director of Revenue Integrity, this role interprets medical record data into payer-understandable coding to facilitate accurate physician charge processing, directly impacting billing accuracy and revenue integrity. Responsibilities:Assign appropriate diagnosis (ICD-10) and procedure codes (CPT/HCPCS) based on medical documentationComplete coding in a timely manner to meet billing deadlinesResolve incomplete or missing documentation to expedite billingCommunicate with healthcare providers to clarify coding questionsPerform claim edit corrections and denial reviews related to coding errorsIdentify and report coding or documentation trends that may risk revenueStay updated on coding guidelines, compliance policies, and payer requirementsPerform other duties as assigned Requirements:Knowledge of ICD-CM, CPT, HCPCS coding systems, and CCI editsFamiliarity with third-party payer requirements and federal/state medical coding regulationsUnderstanding of ICD-10-CM and CPT/HCPC official coding guidelinesKnowledge of medical records content and managementExperience or education working with EMRsProficiency in medical terminologyAwareness of health information laws and patient confidentialityProficient in Microsoft Office applicationsStrong interpersonal and communication skillsAbility to manage work accurately, efficiently, and timelyWillingness to learn new software and systemsProblem-solving skills and persistence in overcoming obstaclesAbility to remain stationary 50-75% of the time Desired Skills:Familiarity with the MassHealth ACO programFamiliarity with Federally Qualified Health CentersExperience with anti-racism activities or lived experience with racism Qualifications:High School Diploma or equivalentCPC Certification3-5 years of outpatient CPT/HCPC coding experience, preferably in a multi-specialty settingPrior Epic experience highly preferred Pay Range and Compensation Package:The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin. Note:RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.