Senior Outpatient Coder

Essentia Health; North Dakota; Remote; USD 32,000 - 47,000; Full time

Benefits offered by this job

Medical insurance

401(k) plan with employer contribution

Tuition reimbursement

Job summary

Essentia Health is seeking a Hospital Outpatient Coder to review clinical documentation and assign ICD-10-CM diagnoses, CPT/HCPCS procedures, and modifiers for complex outpatient encounters. The role requires strong knowledge of coding guidelines and collaboration with clinicians to ensure accurate charges and reimbursements.

You will work in a fast-paced environment with a focus on quality and productivity, supporting the coding denials team and providing教育 on coding practices.

Qualifications

• Completes ICD-10-CM and CPT/HCPCS coding with accuracy
• Identifies documentation gaps to support appropriate reimbursement
• Participates in coding education and denial prevention initiatives

Responsibilities

• Evaluates health record documentation for accurate reimbursement
• Initiates coding queries to clinicians as needed
• Reviews LCD/NCD policies to support medical necessity for services
• Collaborates with the denials team for education and prevention
• Maintains outpatient coding quality (≥95% accuracy) and productivity
• Provides training support to outpatient coders

Skills

ICD-10-CM knowledge

CPT/HCPCS coding

Medical terminology

Documentation clarification

Education

Coding program completed

Tools

Epic

3M Encoder

Computer Assisted Coding

Job description

Building Location:Fargo Distribution Serv CenterDepartment:1006240 HOSPITAL CODING - EH SSJob Description:This position is responsible for reviewing clinical documentation and assigning ICD-10-CM diagnosis, CPT/HCPCS procedure codes, and modifiers to ensure proper reimbursement for complex outpatient accounts. Requires extensive knowledge and understanding of ICD-10-CM and CPT/HCPCS coding guidelines, medical terminology, and disease processes. Works closely with clinicians and operations to ensure complete and accurate documentation, coding, and charges for the services provided. Adheres to the quality and productivity standards set by the department.Education Qualifications:Key Responsibilities:Evaluates health record documentation and accurate reimbursement by ensuring that ICD-10-CM diagnostic and CPT/HCPCS procedural codes, and modifiers accurately reflect and support the hospital-based outpatient encounterIdentifies documentation clarification opportunities to ensure that documentation supports the coding and charges for the services provided. Initiates coding queries and provides feedback to cliniciansReviews Local Coverage Determination (LCD)/National Coverage Determination (NCD) policies for ICD-10-CM diagnoses that support medical necessity for services providedWorks with the coding denials team for education and assists with denial prevention solutionsEnsures outpatient accounts are coded accurately and in a timely mannerConsistently maintains coding quality (95% accuracy) and productivity expectationsAssists with the training of outpatient codersPerforms related duties as requiredEducational Requirements:Successful completion of a coding program, which included coursework in ICD-10-CM, CPT/HCPCS, medical terminology, anatomy and physiology and disease processesRequired Qualifications:Two (2) years of hospital outpatient coding experiencePassing score on the Essentia Health senior outpatient coding skills assessmentPreferred Qualifications:Epic experience3M Encoder experienceComputer Assisted Coding experienceLicensure/Certification Qualifications:Certification/Licensure Requirements:Current certification with American Health Information Management Association (AHIMA) or AAPC and credentialed as Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), and/or Certified Coding Specialist-Physician-Based (CCS-P)FTE:1Possible Remote/Hybrid Option:RemoteShift Rotation:Rotating Shift (United States of America)Shift Start Time:8:00 AMShift End Time:5:00 PMWeekends:Holidays:NoCall Obligation:NoUnion:Union Posting Deadline:Compensation Range:$23.06 - $34.59Employee Benefits at Essentia Health: At Essentia Health, we’re committed to supporting your well-being, growth, and work-life balance. Our comprehensive benefits include medical, dental, vision, life, and disability insurance, along with supplemental options to fit your needs. We offer a 401(k) plan with employer contributions to help you plan for the future, and we invest in your professional development through training, tuition reimbursement, and educational programs. To help you thrive both at work and at home, we provide flexible scheduling, generous time off, and wellness resources focused on your physical, mental, and emotional health. Please note that benefit eligibility may vary. For full details, refer to your benefit summary or contact our HR Service Center at [phone].