Medical Coder - Outpatient

Position Summary

Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) responsible for quality review and analysis of a wide range of patient medical records and ensuring coding accuracy in accordance with accepted medical and legal standards. Reviews physician-selected CPT, HCPCS, and ICD-10-CM codes against documentation to substantiate the level of coding for outpatient specialty encounters, including E/M clinic visits, infusion services, procedures within specialty practices, and related infusion therapy suites. Abstracts additional data elements as needed and works with department and practices to obtain necessary information to accurately code and bill claims to payers. May also perform account creation and charge entry as needed.

Core Job Functions

• Assign codes according to regulatory guidelines.
• Query physicians for missing documentation to ensure accurate coding.
• Keep accounts from being finalized until documentation responses are received.
• Abstract key data elements for regulatory reporting.
• Review records for additional information needed for claim submission.
• Apply occurrence codes when not captured at the time of admission.