Outpatient Coding Specialist
Core
Review outpatient medical records to assign ICD-10-CM diagnosis codes and support claims processing and reporting.
Role type
Outpatient Coding Specialist
Builds
Accurate medical coding and billing data for claims processing
Domain
Healthcare / Medical Billing
Required skills
ICD-10-CM coding, medical necessity review, encoder tools, Cerner billing system, regulatory compliance (CMS/AHIMA), revenue cycle management
Preferred skills
Ambulatory Payment Classifications (APCs), coding modifiers, accounts receivable processes, electronic health record systems
Responsibilities
Review outpatient and ancillary medical records to identify diagnoses and verify documentation; Assign ICD-10-CM diagnosis codes using coding software; Verify medical necessity requirements and investigate potential denials; Review charges in the Cerner billing system for accuracy; Monitor pre-bill reports and complete coding assignments within deadlines; Participate in training to maintain coding expertise and fulfill continuing education requirements.
Seniority
Mid-level, individual contributor
