The Outpatient Medical Coder is responsible for reviewing clinical documentation and accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for outpatient hospital and Rural Health Clinic (RHC) services. This position supports compliance with federal and state regulations, payer guidelines, and organizational policies while helping ensure accurate reimbursement and revenue cycle performance.
The coder works independently in a fully remote environment while maintaining productivity, quality, and communication expectations.
Essential duties include:
- Review outpatient medical records and assign accurate ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS Level II codes.
- Code outpatient encounters for Critical Access Hospital (CAH) departments, including Emergency Department, Observation, Surgery, Ancillary Services, Infusion, Therapy, and Clinic visits as applicable.
- Assign appropriate coding for Rural Health Clinic (RHC) encounters in accordance with CMS regulations and payer requirements.
- Ensure documentation supports all assigned diagnosis and procedure codes.
- Apply National Correct Coding Initiative (NCCI) edits, Medicare guidelines, and payer-specific coding rules.
- Query providers for documentation clarification when necessary.
- Assist with charge review and reconciliation to support accurate and timely billing.
- Participate in coding quality reviews, audits, and compliance initiatives.
- Maintain established coding productivity and quality standards.
- Stay current with coding updates, CMS regulations, and payer requirements.
- Maintain strict compliance with HIPAA and patient confidentiality standards.
- Participate in team meetings, education, and departmental initiatives.
Requirements & Qualifications
Required qualifications
- High school diploma or equivalent required.
- Completion of an accredited medical coding program preferred.
- Current coding certification required: CPC, CCS, or COC.
- Minimum of two years of outpatient coding experience preferred.
- Experience coding for Critical Access Hospitals (CAH) and/or Rural Health Clinics (RHC) strongly preferred.
- Working knowledge of ICD-10-CM, CPT, HCPCS Level II, anatomy, physiology, and medical terminology.
- Experience with electronic health records (EHR) and coding software.
Knowledge, skills, and abilities
- Strong knowledge of outpatient coding guidelines and reimbursement methodologies.
- Knowledge of Medicare, Medicaid, commercial payer requirements, and CMS regulations.
- Understanding of Critical Access Hospital and Rural Health Clinic billing requirements.
- Excellent attention to detail and analytical skills.
- Ability to work independently in a remote environment while meeting productivity goals.
- Strong organizational and time management skills.
- Effective written and verbal communication skills.
- Proficiency with Microsoft Office applications and healthcare information systems.
Performance expectations
- Maintain a minimum coding accuracy rate of 95% or greater.
- Meet established daily productivity and turnaround time standards.
- Respond to internal emails, instant messages, and other work-related communications within 24 hours during normal business operations.
- Maintain coding certification through required continuing education.
- Demonstrate professionalism, accountability, and reliability while working remotely.
- Follow all organizational policies, HIPAA regulations, and coding compliance standards.
- Participate in coding audits, educational opportunities, and quality improvement initiatives.
Remote work requirements
- Dedicated home office with a reliable high-speed internet connection.
- Ability to work independently with minimal supervision.
- Availability during scheduled business hours.
- Secure workspace that protects patient confidentiality and complies with HIPAA requirements.
- Participation in virtual meetings, training sessions, and departmental communications as required.
Physical requirements
- Ability to sit for extended periods while working on a computer.
- Frequent use of keyboard, mouse, and telephone.
Location
San Diego, California, US
Employment Type
Contractor
Experience Level
Entry Level
Remote work allowed
Yes
Posted
4 weeks ago
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