Review clinical documentation and diagnostic results to assign appropriate ICD-10-CM and/or CPT codes for billing, internal and external reporting, research, and regulatory compliance.
Under the direction of the HIM Coding Manager, the outpatient coder accurately codes conditions and procedures according to ICD-10-CM Official Guidelines for Coding and Reporting and/or CPT Assistant. The role applies reimbursement methodologies to assigned charts to optimize reimbursement and resolve regulatory edits.
Additional responsibilities include resolving error reports related to the billing process, identifying error patterns, and helping implement workflow changes to reduce billing errors.
Minimum qualifications
- Advanced coding certification credential, such as CCS, CCS-P, CPC, CPC-H, CMC, RHIT, RHIA, RCC, CCA, COC, CIC, CRC, CPC-P, or specialty coding certifications offered by AAPC
- RHIT-eligible candidates may be considered if they sit for the exam within one year of hire
- If hired with CPC-A, full CPC certification must be obtained within 24 months
- For homecare roles, HCS-D certification is required within 16 months of hire
Education
- Associate degree in Health Information Management required
Additional experience notes
- Grandfathered candidates may need 2 years of relevant coding experience plus a qualifying coding certification and an associate degree in Health Information Management
Responsibilities
- Follow AHIMA Standards of Ethical Coding and official coding guidelines
- Review provider documentation to assign diagnoses and surgical/procedure codes using ICD-10-CM and CPT
- Meet departmental productivity standards with 95% accuracy
- Use Care Connect, UDS, and Clintegrity systems to obtain codes
- Apply APC/E-APG reimbursement expertise
- Prepare compliant coding queries when documentation is unclear or incomplete
- Update data accurately in departmental systems
- Assist physicians and clinical quality staff with documentation, reimbursement, and quality improvement questions
- Assign discharge disposition and/or modifiers according to coding guidelines
- Analyze documentation for charge capture requirements
- Correct claim errors, billing edits, and account misclassifications
- Attend team meetings and required training sessions
Location
New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
6 days ago