About this role
Review physician documentation, medical records, and outpatient encounters.
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Assign accurate ICD-10-CM, CPT, and HCPCS codes.
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Apply outpatient coding and billing guidelines correctly.
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Validate diagnoses, procedures, modifiers, and medical necessity where applicable.
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Identify missing, unclear, or conflicting documentation and escalate queries appropriately.
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Ensure accurate sequencing of diagnoses and procedures.
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Review coding edits, denials, and documentation-related issues.
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Maintain productivity and accuracy targets.
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Follow HIPAA/privacy and organizational compliance requirements.
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Keep up to date with annual coding guideline and code-set changes.
Knowledge of ICD-10-CM, CPT, and HCPCS coding.
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Understanding of outpatient/ambulatory coding guidelines.
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Medical terminology and anatomy knowledge.
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Strong attention to detail and analytical skills.
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Experience with EHR/EMR and coding software is preferred.
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CPC, CCS, CCA, or equivalent certification is often preferred or required, depending on the employer.
Typical