Senior Outpatient Coder - Lead Appeals & Complex Coding

Westchester Medical Center; Town of Mount Pleasant (NY); On-site; USD 70,000 - 100,000; Full time

Job summary

Westchester Medical Center is seeking a Senior Outpatient Coder to handle appeals and code highly complex medical records using ICD-10-CM, CPT, and HCPCS. The role includes leading guidance and ensuring accurate APC/APG assignments.

The ideal candidate will have at least three years of outpatient acute care coding experience, a strong coding assessment showing proficiency in ICD-10-CM and CPT, and relevant coding certifications such as CCS, CCS-P, or CPC.

Qualifications

• Minimum 3 years of outpatient coding experience in an acute care setting.
• Proficiency in ICD-10-CM and CPT with a coding assessment.
• Certified CCS/CCS-P or CPC required; RHIA/RHIT preferred.

Responsibilities

• Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.
• Interprets and applies AHIMA guidelines to support diagnoses and procedures.
• Identifies patterns in coding errors or trends and reports to coding leadership.
• Participates in mandated medical record review processes.
• Assigns and records codes for diagnoses and procedures from the attending physician.
• Enters final codes into automated grouper system and ensures APC/APG ranking.
• Compiles appeal logs detailing denials, replies, and follow-ups.
• Abstracts information from records to compile reports and statistics.
• May train lower-level coders and provide technical guidance.
• Query provider for documentation of diagnosis or procedure.

Skills

ICD-10-CM proficiency

CPT coding proficiency

Analytical skills

Education

High School diploma or equivalent

30 credits toward Associate’s/Bachelor’s in health information management

Job description

Westchester Medical Center is seeking a Senior Outpatient Coder to handle appeals and code highly complex medical records using ICD-10-CM, CPT, and HCPCS. The role includes leading guidance and ensuring accurate APC/APG assignments.

The ideal candidate will have at least three years of outpatient acute care coding experience, a strong coding assessment showing proficiency in ICD-10-CM and CPT, and relevant coding certifications such as CCS, CCS-P, or CPC.