The role involves accurately assigning codes for diagnoses, procedures, and ancillary services in a hospital outpatient setting. The coder will also identify and resolve coding edits and charge discrepancies to ensure proper facility billing.
Description
GeBBS Healthcare Solutions, a nationally recognized leader in Health Information Management (HIM) and Revenue Cycle Management (RCM), is seeking an Outpatient Department Facility Coder with interventional cardiology experience. We are seeking coding professionals with a proven ability to work in a fast-paced, quality-driven environment for a W-2 position on a part time, remote basis.
Requirements
Technical Skills:
- Advanced knowledge of ICD-10-CM, CPT, HCPCS Level II, and modifier assignment for hospital outpatient services.
- Strong understanding of Official Coding Guidelines, CPT rules, Coding Clinic guidance, and CMS outpatient billing regulations.
- Proficiency in applying National Correct Coding Initiative (NCCI) edits and Outpatient Code Editor (OCE) edits.
- Knowledge of hospital outpatient reimbursement systems, including APC (Ambulatory Payment Classification) and OPPS (Outpatient Prospective Payment System).
- Ability to accurately interpret clinical documentation to support coding of diagnoses, procedures, and ancillary services.
- Strong understanding of medical terminology, anatomy, physiology, pharmacology, and disease processes relevant to outpatient care.
- Proficiency in assigning and validating HCPCS Level II codes for drugs, supplies, and outpatient services.
- Experience using electronic health records (EHRs), encoder systems, CAC tools, and revenue cycle platforms.
- Ability to identify and resolve coding edits, charge discrepancies, and claim issues impacting outpatient facility billing.
Required Experience:
- Minimum of 2–4 years of hospital outpatient coding experience, preferably in a facility (HB) environment.
- Active coding certification from AHIMA or AAPC, such as:
- CCS (Certified Coding Specialist) – strongly preferred
- COC (Certified Outpatient Coder) – strongly preferred for outpatient facility coding
- CPC (Certified Professional Coder) – acceptable with strong outpatient facility experience
- RHIT or RHIA
- Must maintain active credential status with required continuing education units (CEUs) per certifying body requirements.
- Demonstrated experience assigning ICD-10-CM, CPT, HCPCS Level II, and modifiers for outpatient hospital services.
- Experience working with APC/OPPS reimbursement methodology and outpatient hospital billing processes.
- Strong understanding of Official Coding Guidelines, Coding Clinic guidance, CPT rules, NCCI edits, and OCE edits.
- Experience reviewing clinical documentation to support accurate coding and charge capture in a hospital outpatient setting.
- Familiarity with electronic health records (EHRs), encoder software, CAC tools, and revenue cycle systems.
- Experience identifying coding errors, resolving claim edits, and supporting denial prevention efforts preferred.
- Prior experience in a hospital, health system, or large integrated delivery network (IDN) preferred.