Senior Outpatient Coder

Description

: This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, CPT / HCPCS procedure codes, and modifiers to ensure proper reimbursement for complex outpatient accounts. Requires extensive knowledge and understanding of ICD-10-CM and CPT / HCPCS coding guidelines, medical terminology, and disease processes. Works closely with clinicians and operations to ensure complete and accurate documentation, coding, and charges for the services provided. Adheres to the quality and productivity standards set by the department.

Education Qualifications :

Key Responsibilities :

Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and CPT / HCPCS procedural codes, and modifiers accurately reflect and support the hospital-based outpatient encounter

Identifies documentation clarification opportunities to ensure that documentation supports the coding and charges for the services provided. Initiates coding queries and provides feedback to clinicians

Reviews Local Coverage Determination (LCD) / National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services provided

Works with the coding denials team for education and assists with denial prevention solutions

Ensures outpatient accounts are coded accurately and in a timely manner

Consistently maintains coding quality (95% accuracy) and productivity expectations

Assists with the training of outpatient coders

Performs related duties as required

Educational Requirements :

Successful completion of a coding program, which included coursework in ICD-10-CM, CPT / HCPCS, medical terminology, anatomy and physiology and disease processes

Required Qualifications :

Two (2) years of hospital outpatient coding experience

Passing score on the Essentia Health senior outpatient coding skills assessment

Preferred Qualifications :

Epic experience

3M Encoder experience

Computer Assisted Coding experience

Licensure / Certification Qualifications :

Certification / Licensure Requirements :

Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and / or Certified Coding Specialist-Physician-Based (CCS-P)

FTE :

Possible Remote / Hybrid Option :

Remote

Shift Rotation :

Day Rotation (United States of America)

Shift Start Time : Days

Shift End Time : Days

Weekends : No

Holidays : No

Call Obligation : No

Union :

DC USWA Main & Neighborhoods (DCUMN)

Union Posting Deadline :

11 / 4 / 2025

Compensation Range :

$ - $35.28Employee Benefits at Essentia Health :

At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at (218) 576-0000.