Outpatient Coder

Role Summary

Responsible for reviewing medical records and assigning accurate CPT, HCPCS, ICD-10-CM, and appropriate modifiers for outpatient services. This role supports compliant coding and consistent performance across a variety of outpatient encounter types.

Core Responsibilities

• Review medical records and assign accurate CPT/HCPCS, ICD-10-CM, and modifiers.
• Ensure documentation supports coded services and identify/escalate discrepancies or gaps.
• Ensure compliance with CMS, payer-specific rules, and official coding guidelines (including NCCI edits).
• Maintain established quality metrics (e.g., =95% coding accuracy) and meet productivity standards.

Requirements

• Minimum Qualifications:
  • Credentials: CPC, CCS, RHIA, or RHIT (active).
  • Experience: Minimum 3+ years outpatient coding experience across multiple outpatient service types.
• Skills & Knowledge:
  • Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, and NCCI edits.
  • Familiarity with CMS guidelines and outpatient workflows.

Client & Specialty Alignments

• Service Areas: Recurring/Outpatient Clinics.
• Specialty Expectations: Strong knowledge of E/M coding, diagnosis assignment, and CPT coding for clinic-based services.

Note

• Note: Some positions may require evening or weekend coverage based on client needs or project scope.