Outpatient Coder

Rochester Regional Health

3d • $21 - $30 • Remote

About The Position

The Outpatient Coder reviews clinical documentation and diagnostic results to extract data and assign appropriate ICD-10-CM and ICD-10-PCS codes for billing, internal and external reporting, research, and regulatory compliance. The role applies knowledge of reimbursement methodologies to assigned charts to optimize reimbursement and resolve regulatory edits. It also resolves billing-process error reports, identifies patterns, and may assist with designing and implementing workflow changes to reduce billing errors.

This is a full-time remote position in the Coding/Clinical Documentation department in Riedman, with a Monday–Friday schedule from 8:00 AM to 4:30 PM. The position requires an associate degree in Health Information Management and one of the listed coding or health information credentials. At least two years of progressive coding experience in a hospital or multi-specialty physician practice setting is preferred.

Requirements

• An associate degree in Health Information Management is required.
• One of the following credentials is required: Certified Coding Specialist (CCS), Certified Coding Specialist–Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Professional Coder Hospital Based (CPC-H), Certified Medical Coder (CMC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder Apprentice (CPC-A), or a specialty coding certification.
• Candidates with an associate degree from an accredited American Health Information Management Association (AHIMA) program must sit for the RHIT exam within one year of hire.
• Employees hired with CPC-A certification from AAPC must obtain full CPC certification within 24 months of hire.
• For Homecare, Homecare Diagnosis Coding Specialist (HCS-D) certification is required within 16 months of hire.
• For employees hired on or before September 30, 2018, the grandfather clause requires two years of relevant work experience, one of the listed coding credentials (CCS, CCS-P, CPC, CPC-H, CMC, RHIT, RHIA, or specialty coding certification), and an associate degree in Health Information Management.
• The role requires prolonged sitting for 67–100% of the workday, minimal physical effort, lifting under 10 pounds, fine motor skills for computer work, writing, and telephone use, and clear visual and auditory ability.
• The role involves extended concentration, frequent interruptions, independent decision-making, and information processing. Administrative areas in healthcare environments may occasionally involve contact with infectious agents.

Nice To Haves

• At least two years of progressive coding experience in a hospital or multi-specialty physician practice setting is preferred.

Responsibilities

• Follow AHIMA Standards of Ethical Coding and official coding guidelines, and stay current with coding changes and code interpretations.
• Review inpatient record documentation and assign diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS.
• Meet established departmental productivity guidelines while maintaining 95% accuracy consistently.
• Use Care Connect, UDS, and Clintegrity systems to obtain ICD-10 codes and DRG assignments.
• Formulate compliant physician coding queries when documentation is inadequate, ambiguous, or unclear for coding purposes.
• Correct failed-claim billing edits, misclassified accounts, and other errors identified through auditing processes in a timely manner.
• Assist physicians and clinical quality staff with clinical documentation opportunities, coding reimbursement issues, and the quality-improvement review process.
• Identify billing error patterns and, when necessary, assist in designing and implementing workflow changes to reduce billing errors.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree