Outpatient Coder - Provider Based / Pro-Fee and Hospital Based

Impact Advisors is seeking an experienced outpatient medical coder to review clinical documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes for diagnoses, procedures, and services rendered.

The role supports optimal reimbursement and compliance with federal, state, and payer requirements. It also involves identifying coding trends and discrepancies, collaborating with coders, clinicians, and revenue cycle teams, and escalating coding issues to leadership as needed.

Responsibilities

• Monitor outpatient coding work queues and unbilled accounts to support timely filing and claims submission.
• Review patient medical records to assign and sequence codes according to industry-standard coding guidelines.
• Review and resolve coding-related edits such as NCCI, LCD/NCD, and modifier usage to prevent first-pass denials.
• Ensure coding accuracy to support correct billing and minimize claim denials or delays.
• Work closely with providers to clarify documentation and ensure coding accuracy based on organizational policy.
• Maintain current knowledge of coding guidelines, payer requirements, and regulatory changes.
• Follow HIPAA and confidentiality guidelines regarding patient health information.
• Use electronic health records and coding software to code services and enter data.
• Participate in coding education and training as needed.
• Meet daily goals and deadlines so claims are coded within timely filing deadlines.

Performance Metrics

• Coding accuracy rate greater than 95%.
• Productivity standards must be met based on specialty.
• Timely coding within 48 hours of documentation availability.
• Reduction in claim denials related to coding errors.