An Outpatient Medical Coderis responsible for accurately reviewing and coding medical records for services provided in outpatient settings such as clinics, physician offices, ambulatory surgery centers, and hospital outpatient departments.
Review patient medical records, physician notes, and supporting documentation for outpatient visits
Assign accurate ICD-10-CM, CPT, and HCPCS Level IIcodes for diagnoses, procedures, and services
Ensure proper code sequencing and compliance with payer guidelines (Medicare, Medicaid, commercial insurers)
Verify medical necessity and ensure documentation supports billed services
Apply modifiers correctly to optimize reimbursement and reduce denials
Work with providers to clarify incomplete or unclear documentation
Stay updated with coding guidelines, regulatory changes, and payer-specific rules
Maintain productivity and accuracy standards set by the organization
Assist with denial management and resubmissions when required
Ensure compliance with HIPAA and patient confidentiality regulations
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