OP Medical Coder

Job description

Review physician documentation, medical records, and outpatient encounters.

o

Assign accurate ICD-10-CM, CPT, and HCPCS codes.

o

Apply outpatient coding and billing guidelines correctly.

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Validate diagnoses, procedures, modifiers, and medical necessity where applicable.

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Identify missing, unclear, or conflicting documentation and escalate queries appropriately.

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Ensure accurate sequencing of diagnoses and procedures.

o

Review coding edits, denials, and documentation-related issues.

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Maintain productivity and accuracy targets.

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Follow HIPAA/privacy and organizational compliance requirements.

o

Keep up to date with annual coding guideline and code-set changes.

Responsibilities:

- Review physician documentation, medical records, and outpatient encounters.

- Assign accurate ICD-10-CM, CPT, and HCPCS codes.

- Apply outpatient coding and billing guidelines correctly.

- Validate diagnoses, procedures, modifiers, and medical necessity where applicable.

- Identify missing, unclear, or conflicting documentation and escalate queries appropriately.

- Ensure accurate sequencing of diagnoses and procedures.

- Review coding edits, denials, and documentation-related issues.

- Maintain productivity and accuracy targets.

- Follow HIPAA/privacy and organizational compliance requirements.

- Keep up to date with annual coding guideline and code-set changes.

Requirements:

- Knowledge of ICD-10-CM, CPT, and HCPCS coding.

- Understanding of outpatient/ambulatory coding guidelines.

- Medical terminology and anatomy knowledge.

- Strong attention to detail and analytical skills.

- Experience with EHR/EMR and coding software is preferred.

- CPC, CCS, CCA, or equivalent certification is often preferred or required, depending on the employer.

- Typical

Responsibilities

• Review physician documentation, medical records, and outpatient encounters.
• Assign accurate ICD-10-CM, CPT, and HCPCS codes.
• Apply outpatient coding and billing guidelines correctly.
• Validate diagnoses, procedures, modifiers, and medical necessity where applicable.
• Identify missing, unclear, or conflicting documentation and escalate queries appropriately.
• Ensure accurate sequencing of diagnoses and procedures.
• Review coding edits, denials, and documentation-related issues.
• Maintain productivity and accuracy targets.
• Follow HIPAA/privacy and organizational compliance requirements.
• Keep up to date with annual coding guideline and code-set changes.

Requirements

• Knowledge of ICD-10-CM, CPT, and HCPCS coding.
• Understanding of outpatient/ambulatory coding guidelines.
• Medical terminology and anatomy knowledge.
• Strong attention to detail and analytical skills.
• Experience with EHR/EMR and coding software is preferred.
• CPC, CCS, CCA, or equivalent certification is often preferred or required, depending on the employer.
• Typical