Coding Specialist – Outpatient

Jobtailor; Providence (RI); On-site; USD 60,000 - 85,000; Full time

Job summary

Jobtailor is seeking an outpatient coder to review medical records, extract data, and assign ICD-10-CM, CPT, E/M, and HCPCS codes. The role emphasizes accurate documentation and adherence to medical necessity requirements.

You will collaborate with physicians to resolve documentation gaps and ensure timely, accurate billing using 3M 360 Finder. Ideal candidates have 1–2 years of outpatient coding/billing experience, AHIMA or AAPC certification, and the ability to maintain a high accuracy rate

Qualifications

• High school diploma or equivalent.
• Completion of a formal coding educational program.
• Certification in coding from AHIMA or AAPC is required.
• 1–2 years of outpatient coding or billing experience.
• Ability to read and understand outpatient clinic, ancillary, and endoscopy documentation.
• Must meet quality and productivity standards; accuracy target 95%.
• Knowledge of outpatient ICD-10-CM, HCPCS, and E/M guidelines.

Responsibilities

• Review outpatient clinical documentation and medical records to assign ICD-10-CM, CPT, E/M, APC, chargemaster, injection, and infusion codes.
• Extract data and ensure documentation supports assigned codes.
• Use 3M 360 Finder to assign codes and resolve coding and claims edits.
• Apply NCCI, CCI, NCD, OCE, and medical necessity requirements.
• Consult with physicians for clarification and report documentation insufficiencies.
• Monitor outpatient uncoded reports and ensure timely coding and billing.
• Resolve rejected accounts and eClinicalWorks error reports.
• Research and resolve coding, chargemaster, and billing issues.
• Refer complex coding issues to the coding validator or supervisor.
• Maintain patient financial accounts and rebill as required.
• Uphold coding knowledge, quality, productivity, and accuracy standards.
• Perform related clerical duties.

Skills

Data Extraction

Medical Record Review

Coding Knowledge

Documentation Support

Quality Standards Maintenance

Billing Issue Resolution

Patient Financial Accounts Update

HCPCS Knowledge

Evaluation and Management Guidelines

Education

High school diploma or equivalent

Formal coding educational program

Tools

3M 360 Finder

EClinicalWorks

Job description

• Report to the Coding Manager
• Review outpatient clinical documentation and medical records
• Extract data and assign appropriate ICD-10-CM, CPT, E/M, APC, chargemaster, injection, and infusion codes
• Ensure documentation supports assigned codes
• Use 3M 360 Finder to assign codes and resolve coding and claims edits
• Apply NCCI, CCI, NCD, OCE, and medical necessity requirements
• Confer with physicians for clarification and report documentation insufficiencies
• Monitor outpatient uncoded reports and ensure timely coding and billing
• Resolve rejected accounts, claims edit reports, and eClinicalWorks error reports
• Research and resolve coding, chargemaster, medical necessity, and billing issues
• Refer complex coding issues to the coding validator or supervisor
• Update patient financial accounts and rebill accounts as required
• Maintain coding knowledge, quality, productivity, and accuracy standards
• Perform related clerical duties

Requirements

• High school diploma or equivalent
• Successful completion of a formal coding educational program
• Coding certification required from AHIMA or AAPC
• One to two years of experience in outpatient coding or billing
• Ability to read and understand outpatient clinic, ancillary, and endoscopy medical record documentation
• Ability to meet and maintain established quality and productivity standards
• Maintain an average accuracy rating of 95%
• Knowledge of outpatient ICD-10-CM Official Guidelines for Coding and Reporting
• Knowledge of AHA HCPCS Coding Clinics
• Knowledge of NCCI edits and medical necessity requirements
• Knowledge of Rhode Island Hospital Facility Coding Guidelines for adult patients
• Knowledge of 1995 Evaluation and Management Guidelines for patients under 18
• Ability to work under stressful conditions
• Ability to sit for long periods and lift at least 25 pounds; bend, stoop, stretch, and use step-stools
• No supervisory experience required; supervisory responsibility is none

Core Competencies

Demonstrates expertise in outpatient coding, including proficiency in ICD-10-CM, CPT, and E/M coding, while ensuring compliance with medical necessity and documentation standards. Maintains high accuracy and productivity in coding practices, supported by relevant certifications and knowledge of coding guidelines.

Highest-signal resume keywords

• ICD-10-CM Coding
• CPT Coding
• Outpatient Coding Experience
• Coding Certification (AHIMA or AAPC)
• NCCI Edits Knowledge

ATS Optimization Keywords

Hard Skills

• Data Extraction
• Medical Record Review
• Coding and Claims Resolution
• Documentation Support
• Quality Standards Maintenance
• Billing Issue Resolution
• Patient Financial Account Updates
• Coding Knowledge Maintenance
• Outpatient HCPCS Knowledge
• Evaluation and Management Guidelines Knowledge

Soft Skills

• Attention to Detail
• Ability to Work Under Stress
• Communication with Physicians

Certifications & Qualifications

• Coding Certification (AHIMA or AAPC)

Industry Keywords

• Outpatient Coding
• Medical Necessity Requirements
• Chargemaster
• NCCI
• CCI
• NCD
• OCE
• Rhode Island Hospital Facility Coding Guidelines
• Ancillary Medical Records
• Endoscopy Medical Records

Tools & Technologies

• 3M 360 Finder
• EClinicalWorks