13 facility outpatient coder jobs found in Springfield

Job Title Clinical Documentation Specialist Job Description This position is responsible for reviewing clinical documentation and applying the correct coding and modifiers for clinical services performed in office and/or hospital setting an may include surgical and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is compliant with regulatory regulations, provider documentation guidelines, and CPT documentation and CMS coding guidelines. Principal Responsibilities Responsible for reviewing and analyzing documentation present in the medical record for professional services related to clinic, inpatient and/or outpatient services. Verifying and coding of the diagnosis, evaluation and management, procedures or other codes required for the completeness and accuracy of the record. Codes and/or reviews encounters to identify first-listed diagnosis, co-morbidities, complications,...

Description: Investigates complex healthcare claims flagged by third-party referrals, tips, or external allegations prior to payment. This role combines advanced clinical coding expertise (ICD-10, CPT, HCPCS) with investigative scrutiny. The auditor reviews medical records to verify that documented services match the billed codes, adhere to medical necessity guidelines, and comply with state, federal, and contractual coding regulations. Key responsibilities: Allegation Triaging & Investigation: Analyze incoming third-party referrals, compliance tips, and external fraud allegations to identify specific billing patterns, suspect providers, or unbundled services. Identify potential fraud, waste, abuse, billing irregularities, and patterns of non-compliance through medical record review and claims analysis. Pre-Payment Clinical Review: Perform comprehensive clinical and technical reviews of high-dollar or highly complex medical records before a claim is finalized for payment....

Job TitleClinical Documentation SpecialistJob DescriptionThis position is responsible for reviewing clinical documentation and applying the correct coding and modifiers for clinical services performed in office and/or hospital setting an may include surgical and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is compliant with regulatory regulations, provider documentation guidelines, and CPT documentation and CMS coding guidelines.Principal ResponsibilitiesResponsible for reviewing and analyzing documentation present in the medical record for professional services related to clinic, inpatient and/or outpatient services.Verifying and coding of the diagnosis, evaluation and management, procedures or other codes required for the completeness and accuracy of the record.Codes and/or reviews encounters to identify first-listed diagnosis, co-morbidities, complications, therapeutic and...

Location John H. Stroger, Jr. Hospital Department Health Information Management Shift 7:00 AM - 3:00 PM Pay Range $37.658 hourly Job Summary Under the supervision of a Coding Supervisor, the Health Information Management (HIM) Coder abstracts relevant clinical and demographic information from the medical record to identify the care rendered to the patient for the purpose of reimbursement, research and compliance. The HIM Coder ensures that the medical record reflects accurate attending physician documentation for coding of physician and facility encounters. Assigns ICD-10-CM and PCS codes, CPT-4, and HCPCS Level II codes in accordance with coding and reimbursement guidelines for physician and facility encounters. Abstracts into a group and assigns Diagnosis Related Group (DRG) on inpatient accounts and applies Ambulatory Payment Classifications (APC) to outpatient accounts. With minimal errors, identifies principal and secondary diagnosis and procedures based upon federally...

Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description Required:3-4 years of coding experience in an acute healthcare settingRHIT, RHIA or CCS credentialed The Outpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation...

Facility CoderThe Facility Coder is a Certified Coder that has knowledge and training on coding facility based services. These services could include inpatient, outpatient or claims coding edits related to facility based coding. The Facility Coder is responsible for timely and accurate coding of the medical record, which includes assignment of ICD 10, CPT, HCPCS, PCS and DRG. They are expected to have expert knowledge on all coding guidelines and abides by the standards of ethical coding and maintain 95% of greater quarterly quality score.Education:Required: High School Diploma or EquivalentRequired: Completion of Coding CourseExperience:Preferred: 1-2 years related experienceSkills:Must have the analytical ability to interpret data contained in medical records and assign appropriate codes for accurate billingExpert knowledge in CPT, HCPCS, ICD 10, PCS and DRG classification systemsExcellent written and verbal communication skills, including the ability to communicate with clinical...

Job Summary We are seeking an experienced and certified Medical Coder - Inpatient & Outpatient to join our Health Information Management/Revenue Cycle team.The Medical Coder is responsible for accurately reviewing and coding inpatient and outpatient hospital medical records in accordance with official coding guidelines, CMS requirements, payer regulations, and hospital policies.This position plays an essential role in ensuring coding accuracy, regulatory compliance, timely reimbursement, and the integrity of clinical and financial data.The successful candidate will demonstrate strong knowledge of hospital coding, medical terminology, anatomy and physiology, reimbursement methodologies, and regulatory requirements.Essential Duties and Responsibilities Review inpatient and outpatient medical records and accurately assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on assigned account type. Assign and validate appropriate MS-DRG/APR-DRG, APC, Present on Admission (POA),...

Description Coder OP McKenzie-Willamette Medical Center is your community medical provider, serving the Willamette Valley and its residents. Our 113-bed hospital offers inpatient, outpatient, diagnostic, medical, surgical and emergency care. We are a family of caregivers offering care to our larger family — our community. Hourly Base Rate: $18.28 - $26.37 Shift: Days Hours Per Week: 40 hours Date Posted: 02/20/2026 Job Summary: Certified Coder required. Working knowledge of basic medical terminology, ICD-10, CPT and HCPCS codes. Preferred experience in multiple specialties including: Cardiology, Cardiology diagnostic testing, Cardiothoracic Surgery, Critical Care, General Surgery, Gastroenterology, Pulmonology, Vascular Surgery and Vascular Imaging services. Ability to assign codes to diagnoses, procedures, E&M visits, and diagnostic testing. Ability to research and analyze clinical documentation as well as produce reports from a variety of sources. Ability to work...

**Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) + Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) + Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS code...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

Overview Certified Medical Coder (CPC or CCS) - Remote | WFH job at Get It - Healthcare. Springfield, NJ. Job Summary: We are looking for a detail-oriented and motivated Certified Medical Coder to join our team. As a key member of the coding department, you will be responsible for ensuring the accuracy and quality of medical coding for surgical and hospital outpatient services. You\'ll play an essential role in reviewing patient medical records, assigning proper codes, and supporting billing processes to ensure smooth and efficient medical payment collection. This is an exciting opportunity to contribute your expertise while working remotely in a supportive and dynamic environment. Responsibilities Analyze medical records to assign accurate codes for services, procedures, diagnoses, and treatments. Resolve coding-related billing issues promptly and efficiently. Code and bill for vascular scans and other medical services. Assign appropriate ICD-10 and CPT codes for outpatient...