Outpatient Coder I

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - guide what we do every day.

Under the general direction of the OP Coding Supervisor, the Outpatient Coder I is responsible for comprehensive review of medical record documentation and performing various coding activities in one complex outpatient service line. Duties include coding cases, prioritizing tasks, resolving claim edits, managing individual workload, handling stop bills if assigned, and sending queries to clinical staff as needed.

Responsibilities include:

• Review medical records to determine appropriate ICD-10-CM codes per official guidelines.
• Select accurate CPT codes, modifiers, and ICD-10-PCS where applicable, resolving CCI edits.
• Maintain a minimum 95% coding quality score in diagnostic, procedural, and modifier code selection.
• Meet department productivity expectations for the coding service line.
• Code at least one complex outpatient service line proficiently (e.g., Cardiology, Interventional Radiology, Observation, Oncology, Same Day Surgery).
• Participate in career development via journals, coding articles, research, education sessions, and learning circles.
• Use department resources and follow workflows independently to meet candidate for billing goals.
• Resolve returned coder cases for education/errors and improve ongoing performance.
• Manage coding DNBs, stop bills, projects, and initiatives as assigned.
• Collaborate to maintain accurate policies and procedures.
• Demonstrate enthusiasm for coding profession and engage in departmental goals and vision.

Qualifications:

• Bachelor's degree preferred with coursework in anatomy, physiology, medical terminology, pathophysiology, and disease processes.
• Minimum 2 years outpatient or professional coding experience in complex service line; experience can substitute partly for degree if RHIT/RHIA or CCS/CCS-P credential held.
• Preferred prior experience with Epic and 3M encoder.
• Licensure: CCS, CCS-P, or RHIT credentials preferred; must hold valid coding credential from AAPC and/or AHIMA. CPC-A or CCA not accepted.
• Skills: Comprehensive knowledge of anatomy/physiology, medical terminology, ICD-10-CM/PCS, CPT coding, and professional E/M leveling preferred. Strong communication, critical thinking, reasoning, and time management skills required. Ability to work independently with limited supervision.