Codes and abstracts hospital outpatient medical records for reimbursement, data reporting, research, and compliance with applicable coding guidelines and regulatory requirements.
Assigns appropriate ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS codes based on provider documentation and applicable coding guidelines. Reviews medical records for completeness, accuracy, and appropriate code assignment, identifies documentation deficiencies and coding discrepancies, and coordinates follow-up or clarification when necessary.
Applies established coding standards to support accurate billing, compliant reimbursement, data integrity, and revenue cycle performance.
Education and experience
- High school diploma or equivalent required
- Current coding certification from AAPC or AHIMA required; acceptable credentials may include CPC, COC, CCS, CCA, RHIT, RHIA, or another approved credential
- Minimum of 2-3 years of hospital outpatient coding experience required
- Previous medical billing, claims processing, or revenue cycle experience preferred
- Experience with electronic health records and computerized coding/encoding software required
Knowledge and skills
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems
- Familiarity with hospital outpatient coding for emergency department, outpatient surgery, observation, rehabilitation, infusion, and similar services
- Ability to research coding questions using authoritative resources and apply current guidance
- Understanding of coding edits, modifiers, payer billing rules, medical necessity, and reimbursement principles
- Knowledge of official coding guidelines, regulatory requirements, and compliance standards
- Ability to review documentation for completeness and accuracy, identify discrepancies, and determine when clarification is needed
- Strong attention to detail, analytical thinking, problem-solving, and ability to work independently
- Ability to maintain confidentiality and communicate professionally with physicians and hospital staff
Benefits package
- Medical
- Dental
- Vision
- 457B retirement plan with employer match for full-time employees
- Company-paid short-term disability (STD)
- Company-paid long-term disability (LTD)
Location
Illinois, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago