Outpatient Coder Lead

CommonSpirit Health; United States; On-site; USD 90,000 - 120,000; Full time

Job summary

CommonSpirit Health seeks an Outpatient Coder Lead to direct outpatient coding operations, ensure complete charge capture, and provide expert guidance to staff. You will manage education, audits, denials, and data submissions to align with coding compliance plans and corporate financial goals.

The role requires expert outpatient coding proficiency, advanced knowledge of ICD-10-CM, CPT, HCPCS, and coding clinics, plus leadership experience in an acute care setting.

Qualifications

• Must have strong outpatient coding knowledge and leadership ability.
• Experience in coordinating service center operations, training, and quality reviews.
• Solid understanding of ICD-10-CM, CPT, HCPCS coding systems.
• Active credentials (RHIA, RHIT, CCS, CCS-P, or AAPC/CPC, CIC, COC, CPC-H).

Responsibilities

• Direct Outpatient Coding Service Center operations, including personnel management and productivity.
• Provide coding education, audits, denials, and CHA data submissions.
• Promote standardization and maintain coding compliance to support financial goals.
• Collaborate with Revenue Management and hospital staff to improve data accuracy.

Job description

Outpatient Coder Lead

Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings.

As our Outpatient Coder Lead, you will code and abstract outpatient records for data retrieval, analysis, reimbursement, and research, ensuring complete charge capture, and providing expert guidance to coding and hospital staff.

Every day you will direct Outpatient Coding Service Center operations including personnel management, training, education, productivity, work assignments, and quality reviews. You will assist with coding education, audits, denials, claim edits, and CHA data submissions, promoting standardization and managing DNB and coding compliance to achieve financial goals and improve the accuracy and integrity of patient data.

To be successful in this role, you will possess expert-level outpatient coding proficiency, strong leadership and management skills, a deep understanding of coding regulations and reimbursement methodologies, and the ability to drive accuracy, quality, and standardization across coding operations, while effectively collaborating with Revenue Management and other departments.

• Demonstrates proficiency in coding and abstracting outpatient accounts in the electronic medical record system, completes charge capture/review as applicable, and creates APC group assignments while adhering to coding guidelines, regulations, and compliance plan.
• Conducts and assists quality audit reviews in a timely manner and effectively communicates feedback to stakeholders.
• Answers coding questions in accordance with the Coding Compliance plan, Official Coding Guidelines, and regulatory billing guidelines.
• Assists Manager with managing DNB, coder productivity, and quality to ensure alignment and support of achieving corporate/service center and hospital financial goals.
• Facilitates and/or assists with coding training and education to promote accurate coding and reimbursement practices per coding guidelines, regulatory requirements, and the organization's coding compliance plan.
• Works with the outpatient coding team to improve the coding accuracy, integrity, and quality of patient data, to ensure minimal variation in coding practices.

Required

• High School Diploma/G.E.D.
• Minimum of four (4) years of outpatient coding experience in an acute care setting
• Current AHIMA credentials (i.e. RHIA, RHIT, CCS, CCS-P) or AAPC credential (COC, CIC, CPC-H, CPC)
• Must demonstrate competency of outpatient and observation coding guidelines as well as other outpatient coding guidelines
• Demonstrate advanced knowledge of Coding Clinic Guidelines, and advanced technical knowledge with coding competency in ICD-10 CM, CPT, HCPCS and Nosology
• Advance knowledge of disease management, anatomy and physiology, medical terminology, pharmacology and coding systems (i.e. 3M)

Preferred

• Associate's Degree
• Charge capture experience