Outpatient Department Facility Coder

Gebbs Healthcare Solutions Inc; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

Gebbs Healthcare Solutions Inc is seeking an experienced outpatient coder to join our team. You will assign ICD-10-CM, CPT, and HCPCS Level II codes for hospital outpatient services, ensuring accurate charge capture and compliance.

Strong knowledge of NCCI and OCE edits, APC/OPPS reimbursement, and CMS guidelines is essential. EHR and encoder tools experience is required, with active credentials and CEU maintenance.

Qualifications

• Minimum of 2–4 years of hospital outpatient coding experience.
• Active coding credentials from AHIMA or AAPC required.
• Must maintain ongoing CEUs per certifying body.
• Experience coding ICD-10-CM, CPT, HCPCS Level II and modifiers.
• Experience with APC/OPPS reimbursement and outpatient billing.

Responsibilities

• Assign codes for outpatient hospital services accurately.
• Review clinical documentation to support coding and charge capture.
• Identify and resolve coding edits and claim issues.
• Ensure compliance with Official Coding Guidelines and CMS rules.

Skills

ICD-10-CM coding

CPT coding

HCPCS Level II coding

NCCI edits

OCE edits

OPPS knowledge

EHR proficiency

CODING guidelines

Revenue cycle awareness

Education

AHIMA or AAPC certification

CCS

COC

CPC

RHIT or RHIA

Tools

Encoder systems

CAC tools

EHR systems

Revenue cycle platforms

Job description

Technical Skills:

• Advanced knowledge of ICD-10-CM, CPT, HCPCS Level II, and modifier assignment for hospital outpatient services.
• Strong understanding of Official Coding Guidelines, CPT rules, Coding Clinic guidance, and CMS outpatient billing regulations.
• Proficiency in applying National Correct Coding Initiative (NCCI) edits and Outpatient Code Editor (OCE) edits.
• Knowledge of hospital outpatient reimbursement systems, including APC (Ambulatory Payment Classification) and OPPS (Outpatient Prospective Payment System).
• Ability to accurately interpret clinical documentation to support coding of diagnoses, procedures, and ancillary services.
• Strong understanding of medical terminology, anatomy, physiology, pharmacology, and disease processes relevant to outpatient care.
• Proficiency in assigning and validating HCPCS Level II codes for drugs, supplies, and outpatient services.
• Experience using electronic health records (EHRs), encoder systems, CAC tools, and revenue cycle platforms.
• Ability to identify and resolve coding edits, charge discrepancies, and claim issues impacting outpatient facility billing.

Required Experience:

• Minimum of 2–4 years of hospital outpatient coding experience, preferably in a facility (HB) environment.
• Active coding certification from AHIMA or AAPC, such as:
• • CCS (Certified Coding Specialist) – strongly preferred
  • COC (Certified Outpatient Coder) – strongly preferred for outpatient facility coding
  • CPC (Certified Professional Coder) – acceptable with strong outpatient facility experience
  • RHIT or RHIA
• Must maintain active credential status with required continuing education units (CEUs) per certifying body requirements.
• Demonstrated experience assigning ICD-10-CM, CPT, HCPCS Level II, and modifiers for outpatient hospital services.
• Experience working with APC/OPPS reimbursement methodology and outpatient hospital billing processes.
• Strong understanding of Official Coding Guidelines, Coding Clinic guidance, CPT rules, NCCI edits, and OCE edits.
• Experience reviewing clinical documentation to support accurate coding and charge capture in a hospital outpatient setting.
• Familiarity with electronic health records (EHRs), encoder software, CAC tools, and revenue cycle systems.
• Experience identifying coding errors, resolving claim edits, and supporting denial prevention efforts preferred.
• Prior experience in a hospital, health system, or large integrated delivery network (IDN) preferred.