Senior Outpatient Coder

Westchester Medical Center Health Network; Town of Mount Pleasant (NY); On-site; USD 63,000 - 80,000; Full time

Benefits offered by this job

Health Insurance

Dental

Vision

Retirement Savings Plan

Flexible Savings Account

Paid Time Off

Holidays

Tuition Reimbursement

Job summary

Westchester Medical Center Health Network is seeking a Senior Outpatient Coder in Valhalla, NY to handle appeals and code highly complex medical records using ICD-10-CM, CPT and HCPCS guidelines. You will lead guidance and mentor others as needed.

The role requires at least three years outpatient coding experience in acute care, AHIMA or AAPC certification, and a HS diploma with progress toward an RHIA/RHIT degree preferred. This is a full-time, day shift position.

Qualifications

• Minimum three years of outpatient coding experience in an acute care setting.
• Proficiency in ICD-10-CM and CPT coding.
• Ability to apply AHIMA guidelines to diagnoses and procedures.

Responsibilities

• Address appeals to insurance denials to facilitate reimbursement.
• Interpret and apply coding guidelines for diagnoses and procedures.
• Identify patterns in coding errors and report to leadership.
• Train lower level coders and provide guidance.
• Query providers for documentation when needed.
• Enter codes into automated grouper system and maintain appeal logs.

Skills

ICD-10-CM

CPT coding

Lead/Training

Denials appeals

Education

High School diploma with 30 credits toward AHIMA degree substitution

CCS/CCS-P or CPC certification

RHIA or RHIT certification

Job description

Location: Valhalla, New York, United States

Salary: $30.46-$38.30

Company: WMCHealth

Posted: Senior Outpatient Coder

Company: NorthEast Provider Solutions Inc.

City/State: Valhalla, NY

Category: Clerical/Administrative Support

Department: Health Info Mgmt-WMC Health

Union: No

Position: Full Time

Hours: mon - friday/8-4:30

Shift: Day

Req #: 49680

Posted Date: Sep 02, 2026

Hiring Range: $30.46-$38.30

Job Summary:

The Senior Outpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records, including all diagnoses and operative and diagnostic procedures in patient medical records, using the current International Classification of Diseases (ICD 10CM), Current Procedural Terminology (CPT) and Health Care Financing Administration Common Procedures Coding System (HCPCS), and entering coded information into an automated grouper system. Technical guidance and acting in a lead role is expected. Does related work as required.

Responsibilities:

• Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.
• Interprets and applies American Hospital Association Official Coding guidelines to articulate and support principle and secondary diagnoses and selected procedures.
• Identifies and analyzes patterns in possible coding errors or other trends and reports to the coding leadership team.
• Participates in mandated medical record review processes.
• Using current HCPCS, ICD 10 CM, and CPT coding systems, assigns and records an accurate code to all diagnoses, procedures, and operations as documented by the attending physician in the indicated patient's medical record.
• Ensures that all factors necessary for assigning an accurate APC/APGs are present, and that all diagnoses are ranked properly.
• Makes appropriate contacts in order to acquire or clarify necessary information.
• Enters final diagnostic code numbers and narrative descriptions of diagnoses and procedures into an automated grouper system.
• Compiles and updates the appeal log detailing denials, hospital's reply and follow-up responses.
• Abstracts information from medical records to compile reports and statistical information.
• May train lower level coders and provide technical guidance and expertise.
• Query appropriate provider as necessary regarding documentation of diagnosis and/or procedure.

Qualifications/Requirements:

Experience:

• Minimum of three years of experience where the primary function of the position must have been outpatient coding in acute care setting. Demonstrate proficiency in ICD 10 CM and CPT by passing coding assessment administered before hire.

Education:

• High School or equivalency diploma, required. Satisfactory completion of 30 credits* toward an Associate’s degree or Bachelor’s degree in health information management may be substituted on a year for year basis for up to four years of the general coding experience. There is no substitution for the two years of specialized experience.

Licenses / Certifications:

• Current certification as either a Certified Coding Specialist (CCS) or Certified Coding Specialist-Physician Based (CCS-P) through AHIMA, or as a Certified Professional Coder (CPC) through the American Academy of Professional Coders, required.
• Certification as Registered Health Information Administrator (RHIA) or as a Registered Health Information Technologist (RHIT) by the American Health Information Management Association.

About Us:

NorthEast Provider Solutions Inc.

Benefits:

• Health Insurance
• Dental
• Vision
• Retirement Savings Plan
• Flexible Savings Account
• Paid Time Off
• Holidays
• Tuition Reimbursement