Senior Certified Coding Specialist

Outpatient Coder - SRMC

Title: Certified Outpatient Coder

Department: Health Information Management (HIM)

Reports To: Coding Manager

Type: Full Time

Position Summary:

The Outpatient Medical Coder is responsible for assigning accurate CPT/HCPCS and ICD-10-CM codes for all outpatient encounters, including Emergency Department (ED), Same-Day Surgery, Observation, Ancillary Services, and Specialty Clinic visits. This role ensures coding accuracy for clean claim submission, proper reimbursement, and compliance with all federal, state, and payer-specific coding guidelines.

Key Responsibilities:

Coding and Documentation Review:

• Review medical records to assign appropriate CPT/HCPCS and ICD-10-CM codes based on provider documentation.
• Ensure coding supports medical necessity and complies with National Correct Coding Initiative (NCCI) and Outpatient Prospective Payment System (OPPS) rules.
• Apply appropriate modifiers and resolve outpatient coding edits and denials.
• Ensure proper sequencing of Primary and other relevant secondary diagnosis to the visits as supported by the provider documentation.

Quality & Compliance:

• Maintain outpatient coding accuracy 95% and productivity standards:




• ED: 12-14 charts/hour
• SDS: 4-6 charts/hour
• Ancillary: 20-25 charts/hour




• Follow CMS, AHA, and payer-specific outpatient billing and documentation guidelines.
• Identify and resolved documentation deficiencies by collaborating with the clinical teams.

Continuous Education and Improvement:

• Stay up to date with CPT/ICD code changes, OPPS rules, payer edits, and compliance updates.
• Participate in periodic audits and support corrective actions and training as needed.
• Support accurate revenue cycle performance through timely coding and charge capture.

Qualifications:

• Required Certification: CPC (AAPC), CCS (AHIMA or AAPC-certified)
• Experience: 1.5 to 2 years of outpatient coding in a US hospital or multi-specialty clinic environment
• Expertise in:




• CPT, HCPCS, ICD-10-CM
• Modifier application
• ED, SDS, and specialty clinic coding
• Understanding payer-specific policies, denials, and claim edits




• Proficiency in coding and documentation systems (3M, TruCode, Epic/Cerner)

Benefits including but not limited to: Medical, Vision, Dental, 401K, Paid Time Off.

We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state or local law.