Outpatient Coder Job Description

Outpatient Coder Job Description

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Outpatient coder provides assistance to customers (physicians, clinical quality staff) regarding clinical documentation opportunities, coding reimbursement issues, and quality improvement review process.

Outpatient Coder Duties & Responsibilities

To write an effective outpatient coder job description, begin by listing detailed duties, responsibilities and expectations. We have included outpatient coder job description templates that you can modify and use.

Sample responsibilities for this position include:

Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Organizational Integrity Program, Standards of Conduct, other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior
Assigns and sequences ICD9-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical record
Assures the final diagnoses and operative procedures as stated by the physician and other healthcare provider are valid and complete
Codes and abstracts all necessary information with most accurately describes each documented diagnoses and procedures according to established HIM guidelines and AHIMA code of Ethics
Able to communicate precisely with medical staff and other healthcare providers when querying information regarding diagnoses and procedures
Checks charges to make sure they are accurate and complete
Sends Discern Notification messages to appropriate departments when charges are missing or incorrect
Assures all Medicare edits are addressed by adding appropriate modifiers, if appropriate
Meets coding productivity standards as outlined by department guidelines
Registered Health Information Management Administrator (RHIA)Registered Health Information Management Technician (RHIT) or Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)

Outpatient Coder Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Outpatient Coder

List any licenses or certifications required by the position: CCS, RHIT, RHIA, CPC, CCA, CAC, AAPC, CIRCC

Education for Outpatient Coder

Typically a job would require a certain level of education.

Employers hiring for the outpatient coder job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Education, Health Information Management, Health, Associates, Health Information Technology, Department of Education, Medical, Physiology, Anatomy, Medical Terminology

Skills for Outpatient Coder

Desired skills for outpatient coder include:

Clinical information
Anatomy
Physiology
Medical terminology
Pharmacology
Anatomy and physiology
Federal
Clinical disease process
Excel
Medical terminology to report appropriate diagnoses

Desired experience for outpatient coder includes:

Deliver high quality content, on time and within budget
Update both the scope of work and product spec document for each update throughout the year prior to the kickoff meeting , specifically list all components of the product under component checklist inclusive of each individual attachment, describe in detail update requirements under scope of work, list the official resources to be used, review and update the product spec section of the document
Identify appropriate assignment of CPT and ICD-10 Codes for Outpatient Physician and facility services provided in an Observation service setting
Review charges for accuracy and identify deficiencies in charge capture and documentation
Communicates and resolves coding issues (lacking documentation, physician queries, ) for appropriate follow-up and resolution
Familiar with Coding Clinic and CPT Assistant preferred

Outpatient Coder Examples

1

Outpatient Coder Job Description

Job Description Example
Our growing company is looking for an outpatient coder. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for outpatient coder
  • Analyze medical records, extracting clinical, pathological, therapeutic and epidemiologic data in accordance with established ICD-10-CM coding principles and guidelines
  • Ensure data is optimally coded for research purposes, financial reimbursement, planning, statistics and regulatory reporting
  • Assigning ICD-9-CM and/or ICD-10 diagnosis codes
  • Reviews medical records to determine accurate required abstracting elements (facility/client specific elements) including appropriate discharge disposition
  • Demonstrates ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses (including MCC & CC) and procedures
  • Meets and/or exceeds Conifer’s coding productivity guidelines
  • Communicates and resolves coding issues (lacking documentation, physician queries, ) for appropriate follow-up and
  • Average coding quality standard of =/>95% accuracy per monitoring period
  • Reviews medical records to determine all appropriate diagnostic and procedural code assignments using the appropriate classifications systems
  • Assigns charges for applicable clinics/departments as appropriate
Qualifications for outpatient coder
  • Associated Degree in related field required
  • CPC, CPC-H or CCS credentials required
  • CPT and E/M facility and professional fee knowledge a plus
  • Must be reliable, self directed and self-motivated and able to work in a fast paced environment
  • Coding credential required from AHIMA/AAPC (ROCC, CCS, CPC, COC, CPC-P, RHIT, RHIA)
  • CCS/CPC certification required
2

Outpatient Coder Job Description

Job Description Example
Our company is hiring for an outpatient coder. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for outpatient coder
  • Use and maintain computers, fax machines, copy machines, printers, and other office equipment necessary for efficient processing of patient information and documents
  • Prepare and bill accounts promptly ensuring their accuracy and completeness
  • Direct patients toward appropriate payment options when need is demonstrated
  • Initiate financial evaluation process where indicated for uninsured or underinsured patients
  • Evaluate accounts to insure all 3rd party reimbursement has been exhausted
  • Initiate appropriate follow-up on accounts at proper intervals
  • Research credit balances to assess disposition of funds and process as directed by departmental policy
  • Evaluate and submit accounts for appropriate disposition or preparation for outsourcing
  • As the Coding Technician II gains knowledge, skills and the appropriate additional education and certification, the Coding Technician II may progress in the types of coding~related assignments given and begin to take on the role of coding resource person and/or quality analyst and may have the opportunity to be promoted to higher coding positions
  • Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient’s medical record
Qualifications for outpatient coder
  • Must have an RHIT, RHIA, or CCS certification
  • Prior Evaluation and Management or prior surgical coding experience in cardio thoracic, transplant, or vascular surgery preferred
  • Utilize ICD-10 CM and CPT-4 coding rules and regulations, pertinent reference materials required for the accurate and specific assignment of codes for diagnosis and procedure statements for outpatient medical records utilizing the 3M encoder/grouper
  • This is a remote opportunity
  • 1 year coding/abstracting experience in ICD-9-CM outpatient coding preferred
  • Certification as a Registered Health Information Technician (RHIT), CPC, CCS, certification required
3

Outpatient Coder Job Description

Job Description Example
Our growing company is looking for an outpatient coder. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for outpatient coder
  • Reviews charges, assign charges and assigns appropriate facility E/M level, when applicable
  • Utilizes technical coding principals and APC reimbursement expertise to assign appropriate ICD-9-CM diagnoses and ICD-9-CM/CPT procedures
  • Interacts with medical staff for clarification of documentation
  • May review daily system-generated error reports to correct or complete missing data elements
  • Accurately codes inpatient and outpatient conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting
  • Assure accurate and complete assignment of ICD-9-CM diagnosis codes that are supported by medical record documentation for outpatient records
  • Assure accurate and complete assignment of APCs that are supported by medical record documentation for outpatient records
  • Identify appropriate assignment of CPT and ICD-10 Codes for Outpatient, ED, Ancillary, Observation, Same Day Surgery facility coding services
  • Answer coding and abstracting questions from peers, doctors, hospital employees
  • Review coding denials in assigned work queue(s) to identify deficiencies in CPT code, ICD-10 code and modifier assignment based on clinical documentation in accordance with established coding guidelines, third party payer rules, University Standard Practice Guidelines, CMS rules, regulations and guidance
Qualifications for outpatient coder
  • CPC/CCS/RHIT/RHIA certification
  • Two years coding experience in an acute care setting mandatory
  • Prior Evaluation and Management and/or surgical coding experience preferred
  • Evaluate and interpret health record documentation to accurately assign ICD-10-CM codes to outpatient day surgery, observation and wound care records
  • Knowledgeable in assigning modifiers, CPT and HCPCS codes
  • Demonstrates aptitude to utilize encoder to arrive at accurate code assignment for complex outpatient cases
4

Outpatient Coder Job Description

Job Description Example
Our company is growing rapidly and is looking for an outpatient coder. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for outpatient coder
  • Respond to complex coding inquiries as required
  • Communicate problems and barriers to leadership
  • Model, support and reinforce a culture of service excellence to all customers
  • Participate as an active member of Lean Thinking in daily work initiatives
  • Represent the unit with limited authority regarding general administrative and operational matters on an as need basis
  • Initiate and prepare standardized and ad hoc reports and correspondence based on respective area needs
  • Perform review of Epic edits daily and provide feedback on areas needing improvement
  • Assist co-workers with backlogged coding as required
  • Refer delinquent documentation cases and concerns to physicians for investigation and follow-up
  • Keep abreast of current coding changes and standards of care to maintain RHIT, RHIA, CPC and/or CCS-P certification
Qualifications for outpatient coder
  • Ability to apply definition of principal diagnosis to arrive at correct code assignment for accurate reimbursement
  • Advance knowledge of ICD10 CM and CPT Procedure Guidelines for complex procedures
  • Minimum of three (3) years’ work experience within a hospital-coding department
  • RG RHIA = Registered Health Information Admin or RG HITECH = Registered Health Information Tech or CT CS = Certified Coding Specialist
  • Additional specialized education in coding or combination of education and experience
  • Certified Coding Associate (CCA) or Certified Coding Specialist (CCS) or Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required
5

Outpatient Coder Job Description

Job Description Example
Our company is searching for experienced candidates for the position of outpatient coder. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for outpatient coder
  • Work in several different software programs (MiChart, Centricity, and Provation)
  • Incorporate Lean principles into daily work
  • Keep abreast of current coding changes and standards of care to maintain RHIT, RHIA, CCS-P, CPC, CPC-A certification
  • Work in several differ software programs (EPIC, Centricity and Provation)
  • Upon review of the medical record, performs analysis on documentation, which includes review of tests / reports to determine the appropriate ICD-CM (current edition) and / or CPT codes modifiers
  • Verifies documentation is present to substantiate codes assigned
  • Assists in resolving incomplete and / or missing chart documentation in order to expedite coding and billing
  • Participates in the continuous coding audit and performance management program
  • Maintains coding accuracy rate of not less than 95% for optimal reimbursement department productivity standards as outlined in department policies
  • Attends required training classes and coding in-services each year to stay abreast of new regulations and coding guidelines
Qualifications for outpatient coder
  • Previous related coding experience strongly preferred
  • Demonstrated high attention to detail and accuracy
  • Coding experience with ICD10/CPT/HCPS required
  • Knowledge of AMA coding classifications for Anatomic and Clinical Pathology required
  • Prior Coding experience or graduate of a Coding Program
  • Completion of a high school diploma or equivalent required

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