Coder Outpatient

Omega Healthcare Solutions•Boca Raton, FL

20h

About The Position

This role is for an Outpatient Coder with recent and multiple years' experience coding in a children's hospital or extensive pediatric experience. The position involves multi-specialty coding for both medicine and surgical cases. Candidates should have experience in multiple specialties, though not necessarily all. Required tools include Epic and 3M 360 CAC. The schedule can be flexible after an initial training week, which requires availability between 8a and 4p PST. Post initial training, 50% of the shift should be worked during this timeframe. This is an 8-week project.

Requirements

Recent and multiple years' experience coding in a children's hospital or extensive pediatric experience.
Experience in multi-specialty coding for both medicine and surgical cases, with experience in multiple specialties.
Epic experience.
3M 360 CAC experience.
Availability for initial training (first week between 8a and 4p PST).
Ability to work 50% of the shift during 8a-4p PST post initial training.
Advanced knowledge of ICD‑10‑CM coding for outpatient encounters.
Strong proficiency in CPT®, HCPCS Level II, and modifier usage.
Thorough understanding of Outpatient Prospective Payment System (OPPS) and Ambulatory Payment Classifications (APCs).
Knowledge of National Correct Coding Initiative (NCCI) edits and bundling rules.
Proficiency coding same‑day and scheduled outpatient surgical procedures.
Ability to interpret operative reports, brief op notes, and anesthesia documentation.
Knowledge of global surgical package rules.
Understanding of ASC vs. hospital outpatient surgery coding distinctions (when applicable).
Strong understanding of observation services in a hospital outpatient setting.
Knowledge of observation vs. inpatient status criteria and billing rules.
Familiarity with same‑day admission and discharge scenarios.
In‑depth understanding of pediatric anatomy, physiology, and disease processes.
Experience with pediatric outpatient specialties.
Knowledge of congenital conditions and chronic pediatric diagnoses commonly treated in outpatient and surgical settings.
Strong ability to review and interpret clinic notes, ED notes, operative reports, anesthesia records, observation flowsheets and progress notes.
Ability to identify incomplete or conflicting documentation and missing diagnoses affecting medical necessity.
Skilled application of official coding guidelines to support accurate and compliant code assignment.

Responsibilities

Perform advanced ICD‑10‑CM coding for outpatient encounters.
Apply CPT®, HCPCS Level II, and modifier usage.
Assign first‑listed diagnosis, secondary diagnoses affecting medical necessity, and CPT/HCPCS procedures and services.
Apply National Correct Coding Initiative (NCCI) edits and bundling rules.
Accurately apply modifiers such as ‑25, ‑59, ‑76, ‑77, ‑LT/‑RT, ‑TC/‑26.
Code same‑day and scheduled outpatient surgical procedures, including minor and major surgeries, endoscopic procedures, image‑guided procedures, and pediatric‑specific surgical techniques.
Interpret operative reports, brief op notes, and anesthesia documentation.
Apply global surgical package rules, including global periods, separate reporting of E/M services, and return‑to‑OR scenarios.
Code observation services in a hospital outpatient setting, including observation start and stop times, and initial, subsequent, and discharge observation codes (CPT).
Apply observation coding guidelines in cases involving ED to observation, surgery to observation, and observation to inpatient conversions.
Code age‑specific conditions and procedures accurately, with an in‑depth understanding of pediatric anatomy, physiology, and disease processes.
Code for pediatric outpatient specialties such as pediatric surgery, orthopedics and sports medicine, cardiology and cardiology diagnostics, gastroenterology and endoscopy, pulmonology, oncology and infusion services.
Review and interpret clinic notes, ED notes, operative reports, anesthesia records, observation flowsheets and progress notes.
Identify incomplete or conflicting documentation and missing diagnoses affecting medical necessity.
Apply official coding guidelines to support accurate and compliant code assignment.