Outpatient Coder Lead
About The Position
The Outpatient Coder Lead codes and abstracts outpatient records for data retrieval, analysis, reimbursement, and research; ensures complete charge capture; and provides expert guidance to coding and hospital staff. The role directs Outpatient Coding Service Center operations, including personnel management, training, education, productivity, work assignments, and quality reviews. The lead supports coding education, audits, denials, claim edits, and CHA data submissions; promotes standardization; and manages DNB and coding compliance to support financial goals and improve the accuracy and integrity of patient data. The position collaborates with Revenue Management and other departments to drive accuracy, quality, and standardization across coding operations.
Requirements
- High school diploma or GED.
- At least four years of outpatient coding experience in an acute care setting.
- Current AHIMA credential (RHIA, RHIT, CCS, or CCS-P) or AAPC credential (COC, CIC, CPC-H, or CPC).
- Competency in outpatient and observation coding guidelines, as well as other outpatient coding guidelines.
- Advanced knowledge of Coding Clinic Guidelines and advanced technical coding competency in ICD-10-CM, CPT, HCPCS, and Nosology.
- Advanced knowledge of disease management, anatomy and physiology, medical terminology, pharmacology, and coding systems such as 3M.
- Expert-level outpatient coding proficiency, strong leadership and management skills, and understanding of coding regulations and reimbursement methodologies.
Nice To Haves
- Associate's degree.
- Charge capture experience.
Responsibilities
- Code and abstract outpatient accounts in the electronic medical record system, complete charge capture or review as applicable, and create APC group assignments in accordance with coding guidelines, regulations, and the compliance plan.
- Direct Outpatient Coding Service Center operations, including personnel management, training, education, productivity, work assignments, and quality reviews.
- Conduct and assist with timely quality audit reviews and communicate feedback to stakeholders.
- Answer coding questions in accordance with the Coding Compliance plan, Official Coding Guidelines, and regulatory billing guidelines.
- Assist the Manager with managing DNB, coder productivity, and quality to support corporate, service center, and hospital financial goals.
- Facilitate or assist with coding training and education to promote accurate coding and reimbursement practices.
- Collaborate with the outpatient coding team to improve coding accuracy, data integrity, and quality, and minimize variation in coding practices.
- Assist with denials, claim edits, and CHA data submissions and promote coding standardization.
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
