About this role
Role Description
The Outpatient Coder is responsible for accurate and timely coding of hospital outpatient services, with a primary focus on Emergency Department (ED) facility coding. The coder reviews clinical documentation and assigns appropriate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, modifiers, and facility E/M levels in accordance with official coding guidelines, payer requirements, hospital policies, and regulatory standards.
Emergency Department coding experience is required. Experience with Infusion/Injection and/or Same Day Surgery (SDS)/Ambulatory Surgery coding is preferred but not required. The ideal candidate demonstrates strong knowledge of outpatient hospital coding, medical necessity, NCCI edits, modifier assignment, and documentation requirements. Ability to maintain established productivity and quality standards in a high-volume environment.
Qualifications
Minimum 2 years of recent hospital Emergency Department facility coding experience preferred; demonstrated ED coding experience is required. Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and outpatient hospital coding guidelines. Experience assigning Emergency Department facility E/M levels. Knowledge of NCCI edits, medical necessity requirements, and outpatient reimbursement concepts. Ability to interpret Emergency Department clinical documentation, including physician and nursing documentation. Ability to work independently while meeting established productivity and quality expectations. Strong analytical, organizational, and communication skills. Proficiency with electronic health records and coding/encoder applications.
Requirements
Infusion and Injection coding experience. Same Day Surgery/Ambulatory Surgery coding experience. Experience with Epic Hospital Billing (HB). Experience with coding encoder applications. Experience working coding edits, denials, and claim-related coding reviews.
Certification
One or more nationally recognized coding credentials is preferred, including: CPC – Certified Professional Coder CCS – Certified Coding Specialist COC – Certified Outpatient Coder CCS-P – Certified Coding Specialist – Physician-based RHIT or RHIA Associates or Bachelors preferred