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AI Summary
Outpatient coder with recent and multiple years' experience coding in a children's hospital or extensive pediatric experience. This role will be for multi-specialty coding for both medicine and surgical cases. The role can be utilized in areas where the experience is strongest, thus candidates do not need to be experience all specialties but should have experience in multiple specialties. Epic and 3M 360 CAC experience required. Schedule can be flexible after initial training. For initial training candidate must be available for the first week between 8a and 4p PST. Post initial training 50% of the shift should be worked during this timeframe. This is an 8 week project.
1. Core Outpatient Coding Knowledge & Technical Skills
- Advanced knowledge of ICD‑10‑CM coding for outpatient encounters
- Strong proficiency in CPT®, HCPCS Level II, and modifier usage
- Thorough understanding of Outpatient Prospective Payment System (OPPS) and Ambulatory Payment Classifications (APCs)
- Ability to correctly assign:
- First‑listed diagnosis
- Secondary diagnoses affecting medical necessity
- CPT/HCPCS procedures and services
- Knowledge of National Correct Coding Initiative (NCCI) edits and bundling rules
- Accurate application of modifiers, including but not limited to:
- ‑25, ‑59, ‑76, ‑77, ‑LT/‑RT, ‑TC/‑26
2. Outpatient Surgery Coding Skills
- Proficiency coding same‑day and scheduled outpatient surgical procedures, including:
- Minor and major surgeries
- Endoscopic procedures
- Image‑guided procedures
- Pediatric‑specific surgical techniques
- Ability to interpret:
- Operative reports
- Brief op notes
- Anesthesia documentation
- Knowledge of global surgical package rules, including:
- Global periods
- Separate reporting of E/M services
- Return‑to‑OR scenarios
- Understanding of ASC vs. hospital outpatient surgery coding distinctions (when applicable)
3. Observation & Extended Care Coding
- Strong understanding of observation services in a hospital outpatient setting
- Ability to correctly code:
- Observation start and stop times
- Initial, subsequent, and discharge observation codes (CPT)
- Knowledge of observation vs. inpatient status criteria and billing rules
- Familiarity with same‑day admission and discharge scenarios
- Ability to correctly apply observation coding guidelines in cases involving:
- ED to observation
- Surgery to observation
- Observation to inpatient conversions
4. Pediatric & Specialty‑Specific Expertise
- In‑depth understanding of pediatric anatomy, physiology, and disease processes
- Ability to code age‑specific conditions and procedures accurately
- Experience with pediatric outpatient specialties, such as:
- Pediatric surgery
- Orthopedics and sports medicine
- Cardiology and cardiology diagnostics
- Gastroenterology and endoscopy
- Pulmonology
- Oncology and infusion services
- Knowledge of congenital conditions and chronic pediatric diagnoses commonly treated in outpatient and surgical settings
5. Clinical Documentation Review & Interpretation
- Strong ability to review and interpret:
- Clinic notes
- ED notes
- Operative reports
- Anesthesia records
- Observation flowsheets and progress notes
- Ability to identify:
- Incomplete or conflicting documentation
- Missing diagnoses affecting medical necessity
- Skilled application of official coding guidelines to support accurate and compliant code assignment
Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
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