Hospital Outpatient Coder

Required and Preferred Qualifications

• High School Diploma or GED required; Associate Degree preferred
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required
• 3 to 5 years of experience in emergency room coding, infusion coding, or specialty clinic procedure coding preferred
• 2 years of experience with formal coding training may be considered
• Knowledge of medical terminology required
• Critical Access Hospital and/or Rural Health Clinic coding experience is a plus
• Proficiency with Microsoft Office
• Strong verbal and written communication skills
• Ability to work across multiple client systems and manage competing priorities
• Comfort working in a remote teamwork environment

Key Responsibilities

• Receive and review charge entry data from practice sites
• Identify and investigate incomplete or missing charges
• Abstract clinical information and translate medical documentation into diagnosis and procedural codes
• Sequence codes according to established guidelines
• Apply coding and classification systems accurately for prospective payment reimbursement
• Maintain current knowledge of coding rules and regulations from AMA, CMS, and other payers
• Maintain proficiency in EHR and related systems
• Communicate payer, system, and account issues to management
• Identify medical necessity denial trends and recommend resolution strategies
• Assist with claim submission, unpaid claims follow-up, and denial resolution when needed