Outpatient Coder II
Core
Interprets clinical and diagnostic documentation to process hospital and pro-fee charges for outpatient care episodes, assigning ICD-CM, CPT, and ICD-PCS codes.
Role type
Outpatient Medical Coder
Builds
Hospital and professional fee charges for outpatient encounters
Domain
Healthcare / Medical Billing & Coding
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work -> billing codes and reimbursement data
Required skills
ICD-CM coding, CPT coding, CCI edits, third-party payer requirements, federal/state coding regulations, medical terminology, documentation analysis
Preferred skills
Medical coding certification (CCS/CCS-P), 3 years outpatient coding experience, EM coding experience, Evaluation and Management coding experience
Technologies
ICD-CM, CPT, ICD-PCS, CCI edits
Responsibilities
Review medical records to determine appropriate codes and modifiers; verify documentation substantiates assigned codes; resolve incomplete or missing chart documentation; participate in coding audits and performance management; maintain coding accuracy rate of at least 95%; attend training on new regulations and guidelines; communicate coding irregularities or trends to management.
Seniority
Individual Contributor