Senior Outpatient Coder
# Senior Outpatient Coder **Quorum Health** · United States · `Remote` · `Full Time` 💼 **Уровень роли:** `Senior` 🕒 **Статус:** *Опубликовано: сегодня* · *Источник: Himalayas (JSON API)* --- ### Top Skills & Match 🎯 **Ключевой стек роли:** `[Medical-Coder]` `[Outpatient-Coder]` `[HIM-Coder]` `[Health-Information-Management-Coder]` `[Coding-Specialist]` `[Outpatient-Coding-Specialist]` `[Senior-Medical-Coder]` `[Hospital-Outpatient-Coder]` --- ### About the Role Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You must reside in one of these states to be eligible for this position: Arkansas California Kentucky Massachusetts Nevada New Mexico Oregon Utah Tennessee Texas Wyoming Job Summary: - The Senior Coder supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership and may provide oversight of coding quality, coding edits, auditing, and staff education. - Assigned functions may include inpatient, observation, emergency department, ambulatory surgery, ancillary, clinic, and other hospital-based coding services. - The position supports Revenue Cycle Operations with special projects, including denial review, appeals, discharge-not-final-billed management, regulatory and payer edit review, and process improvement efforts designed to meet organizational goals while promoting accurate, complete, and compliant coding and billing. Duties and Responsibilities: - Provides day-to-day leadership and operational support for assigned inpatient and/or outpatient coding workflows, work queues, facilities, and coding staff, consistent with delegated authority. - Provides direct support to Coding Management, including process improvement, denials, special projects, coding edits, auditing, staff education, and other duties as assigned. - Applies current official coding guidelines and authoritative guidance, including ICD-10-CM/PCS, CPT, HCPCS, UHDDS, Coding Clinic, CMS payment rules, and applicable payer requirements. - Maintains at least 95% coding accuracy, or another threshold established by Coding Leadership, using the organization's approved audit methodology. - Monitors coder productivity and quality at established intervals and provides timely, objective feedback, coaching, and education as directed by Coding Management. - Ensures encounters processed by the coding team include an appropriate documented claim-hold reason before the account appears on the DNFB report. - Collaborates with the CDI/Audit team to confirm second-level review is completed for applicable HAC, PSI, and Never Event cases in accordance with established workflows. - Tracks and trends post-discharge coding queries, supports timely resolution, and provides feedback and education to ensure queries are non-leading, supported by the health record, and compliant with organizational policy and applicable guidance. - Ensures accounts are not final billed until required documentation is available and assigned codes are supported by the health record, consistent with organizational policy and applicable billing requirements. - Coordinate workflow improvements with HIM Operations Team(s). - Assists in developing, implementing, and monitoring coding policies and procedures that support accurate coding, appropriate reimbursement, and compliance with federal and state laws, regulations, official coding guidelines, and payer requirements. - Supports effective collaboration between Coding and CDI staff while maintaining role-appropriate accountability and compliant query practices. - Adheres to the AHIMA Standards of Ethical Coding, the organizational code of conduct, and applicable compliance policies, and promotes compliant coding practices within assigned workflows. - Maintains Discharged Not Final Billed goals established by Coding Leadership without compromising coding accuracy, documentation requirements, or compliance. - Ensures coding policies related to HIM, Revenue Cycle, and Compliance are implemented and monitored within assigned areas. - Implements HIM related projects at the direction of Coding Leadership. - Supports Quality, Risk Management, Case Management, and other departments regarding HIM and coding matters within the scope of the role. - Assists HIM, Coding, and CDI Leadership with the development and implementation of coding and CDI policies and procedures. - Monitors and communicates changes in federal and state laws, regulations, accreditation standards, official coding guidance, CMS NCCI/OCE/MUE edits, and payer requirements that affect Coding and HIM operations. - May develop and deliver staff education, coaching, and reference materials based on audit findings, coding-edit trends, denial trends, regulatory changes, and identified knowledge gaps; documents education as required. - May research, review, resolve, and trend coding edits, including NCCI, OCE, MUE, encoder, claim-scrubber, and payer-specific edits; validates that any modifier or code change is supported by the health record and applicable guidance. - May perform or support prospective, concurrent, and retrospective coding audits using an approved methodology; documents findings, identifies trends and potential overpayments or underpayments, and escalates compliance concerns through established channels. - Protects the confidentiality, integrity, and security of protected health information and accesses only information necessary to perform assigned duties in accordance with HIPAA and organizational policy. - Promptly reports suspected coding, billing, privacy, or compliance concerns through established channels and supports corrective action; does not alter the health record or direct unsupported coding. Knowledge, Skills and Abilities: - Extensive knowledge of OPPS, IPPS, UHDDS, Coding Clinic, official coding guidelines, CMS NCCI/OCE edits, and applicable reimbursement methodologies. - Microsoft Office (Word, One Note, Excel, Outlook, PowerPoint) - Ability to interpret audit findings, coding-edit logic, and payer requirements and translate findings into staff education and process improvement. - Ability to maintain objectivity, confidentiality, and accurate audit documentation and to communicate compliance concerns through established channels. - Excellent verbal and written communication skills. - Ability to meet assigned deadlines. - Extensive knowledge of Anatomy & Physiology, Medical Terminology, and Pathophysiology. Work Experience, Education and Certifications: - EDUCATION: CCS Credential, RHIT or RHIA - EXPERIENCE: 5-10 years progressive HIM coding management experience within an acute care hospital setting. Extensive experience with Revenue Cycle Operations including acute care coding - CERTIFICATION/LICENSURE: RHIA or RHIT or CCS - SOFTWARE/HARDWARE: 3M 360 experience required Travel Requirements: - Expected travel is up to 10% at the request of leadership. Benefits: - Competitive salary and benefits package. - Opportunities for professional development and advancement. - Supportive work environment with a collaborative team. - Comprehensive healthcare coverage. - Retirement savings plan. - Paid time off and flexible scheduling options. - Student loan repayment program. Originally posted on Himalayas
- Medical-Coder
- Outpatient-Coder
- HIM-Coder
- Health-Information-Management-Coder
- Coding-Specialist
- Outpatient-Coding-Specialist
- Senior-Medical-Coder
- Hospital-Outpatient-Coder
Наблюдалась 2026-10-06, впервые 2026-10-06, источник — Himalayas (JSON API).