Job Description
GENERAL SUMMARY:
As an Outpatient Complex Coder, you'll be at the heart of healthcare operations—transforming detailed medical records into accurate, compliant coding that directly impacts patient care and organizational success. You'll apply expert coding principles to analyze and code complex diagnostic and procedural information, ensuring precise reimbursement and billing while maintaining the highest standards of accuracy and compliance.
Your work goes beyond data entry. You'll abstract critical information from medical records to build robust patient databases that fuel medical research, drive quality improvement initiatives, and inform strategic healthcare decisions. By serving as a trusted source of accurate health information, you'll help optimize reimbursement, strengthen provider-patient relationships, and ensure your organization meets all regulatory and accreditation requirements.
Key Responsibilities:
- Analyze complex medical records and accurately code diagnostic and procedural information using established coding principles and current guidelines
- Abstract and compile patient data to support medical research projects, quality improvement initiatives, and administrative decision-making
- Ensure all coding submissions comply with established guidelines, third-party payer policies, regulatory requirements, and accreditation standards
- Optimize reimbursement accuracy while maintaining meticulous attention to detail and coding integrity
- Contribute to a culture of continuous improvement by identifying coding trends and supporting process enhancements
Qualifications:
Qualifications
EDUCATION/EXPERIENCE REQUIRED:
- High School Diploma or G.E.D. equivalent required.
- Additional specialty coding certification required or five (5) years coding experience.
- One to two (1-2) years college or additional coursework in Accounting, Business, Healthcare Administration or Medical Record Sciences preferred.
- Must have a thorough knowledge of anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems.
- Minimum of two (2) years coding experience required. Specialty coding experience preferred.
CERTIFICATIONS/LICENSURES REQUIRED:
- Certification as a Registered Health Information Technician (RHIT), CPC, or CCS certification required.