Senior Outpatient Coding Specialist, FT Remote

University of Maryland Medical System; Baltimore (MD); On-site; USD 55,000 - 80,000; Full time

Job summary

The University of Maryland Medical System seeks a Clinical Coding Specialist to ensure accurate ICD-10 and CPT-4 coding for outpatient services. This role requires a minimum of three years' experience in outpatient coding, preferred certifications, and strong analytical skills.

The specialist will perform coding duties utilizing EHR software like EPIC and must adhere to compliance guidelines. Attention to detail and effective communication with various departments are crucial for success in this position.

Qualifications

• 3+ years of outpatient coding experience in a healthcare setting, including surgical coding.
• Demonstrates proficiency in coding guidelines and tools.
• Strong knowledge of medical terminology and office procedures.

Responsibilities

• Assign ICD-10 and CPT-4 codes for various outpatient services.
• Monitor coding quality accuracy and maintain productivity standards.
• Communicate with departments regarding billing and registration issues.

Skills

ICD-10 coding

CPT-4 coding

Analytical skills

Customer service skills

Attention to detail

EHR software proficiency

Problem-solving skills

Education

High school diploma or equivalent

ICD-10-CM and CPT-4 training

Certification (CCS, RHIT, RHIA, CCA, CPC, COC, CIRCC)

Associate or bachelor's degree (preferred)

Tools

EPIC

3M HDM

Job description

Job Requirements

Under direct supervision, assigns accurate ICD-10 diagnoses, CPT-4 procedure coding, and appropriate modifiers derived from medical record documentation for complex and multi‑specialties that include Emergency Room (ER), ER E/M charging, OP Trauma, Hospital and ASC Surgeries, Observation, Interventional Radiology (IR) & Cardiology, and Claim Edits for facility outpatient encounters for the purpose of appropriate reimbursement, research, and compliance with federal and state regulations. This role is essential for ensuring accurate and timely coding of medical records which directly impacts reimbursement and compliance. It requires expertise in coding guidelines and standards, proficiency in medical coding, and the ability to handle moderate to complex coding scenarios.

Primary Responsibilities

• Serves as a clinical coding subject matter expert and utilizes critical thinking to analyze and evaluate moderate to complex outpatient documentation for the accurate assignment of ICD-10 and CPT-4 codes.
• Identifies and assigns ICD-10 diagnosis codes, CPT-4 procedure codes, and appropriate modifiers to Emergency Room (ER), ER E/M charging, OP Trauma, Hospital and ASC Surgeries, Observation, Interventional Radiology (IR) & Cardiology and Claim Edits for the purpose of hospital reimbursement, research, and compliance with federal and state regulations.
• Monitors assigned work daily to facilitate the billing process within the established timeframes. Codes and abstracts records within timeframes established for each patient type.
• Maintains coding quality accuracy rate of 90%.
• Maintains productivity rate of at least 95%.
• Communicates with various departments within the hospitals regarding billing and registration issues. Refers any problems to management timely, providing clear details.
• Complies with AHIMA standards of ethical coding and coding compliance guidelines.
• Demonstrates support and compliance with University of Maryland Medical System mission, vision, values statement, goals and objectives, and policies. Performs other duties or projects such as coding corrections as assigned by the manager.
• May provide support to PB Outpatient Coding Specialists and/or act as backup, as necessary.
• Perform related duties as assigned.

Work Experience

Education & Experience - Required

• High school diploma or equivalent. Formal ICD-10-CM, and CPT-4 training is required.
• 3 or more years of outpatient coding experience in a facility healthcare setting which must include Outpatient Surgical coding.
• Must have one of the following certifications: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Associate (CCA), Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC).

Education & Experience - Preferred

• Associate or bachelor’s degree is preferred.

Knowledge, Skills, & Abilities

• Ability to utilize coding and EHR software (e.g., EPIC, 3M HDM) efficiently to perform coding duties.
• Knowledge and a good understanding of NCCI edits, NCD & LCD requirements, and payer guidelines.
• Strong analytical, organizational, and attention to detail skills.
• Ability to prioritize workload, meet deadlines, and work effectively under pressure.
• Excellent customer service skills.
• Knowledge of general office procedures and filing systems.
• Strong problem‑solving skills.
• Ability to work under minimal supervision.
• Familiar with basic medical terminology.
• Strong computer skills and typing ability.