Facility Clinic Outpatient Coding Specialist

Job Overview

Ocean Health Executives is seeking an experienced and highly motivated Facility Outpatient Clinic Coder to support hospital-based outpatient clinic coding operations. The ideal candidate will possess strong knowledge of outpatient facility coding, hospital clinic charging workflows, and facility Evaluation \& Management (E\&M) level assignment methodologies.

This position is responsible for accurate assignment of ICD-10-CM, CPT, HCPCS, and facility E\&M levels for hospital outpatient clinic encounters while ensuring compliant reimbursement and adherence to payer and regulatory guidelines.

Responsibilities

• Review and code hospital-based outpatient clinic encounters accurately and efficiently
• Assign ICD-10-CM diagnosis codes, CPT procedure codes, HCPCS Level II codes, and applicable modifiers based on provider documentation and coding guidelines
• Review clinical documentation and assign appropriate facility Evaluation \& Management (E\&M) levels for outpatient clinic encounters in accordance with organizational guidelines, CMS regulations, payer requirements, and facility charging methodologies
• Validate supporting documentation for facility E\&M level assignment, including nursing interventions, resource utilization, treatment intensity, and ancillary services provided during the encounter
• Ensure compliant application of facility-specific E\&M leveling criteria and identify documentation opportunities impacting charge capture and reimbursement
• Ensure appropriate facility charging and outpatient reimbursement compliance
• Review documentation for medical necessity, completeness, and coding specificity
• Identify documentation deficiencies and communicate clarification opportunities when appropriate
• Maintain productivity and quality standards established by the organization and client
• Work assigned coding work queues and resolve coding edits as needed
• Collaborate with revenue cycle, CDI, compliance, and operational teams to resolve coding and billing issues
• Stay current with coding updates, payer requirements, and regulatory changes affecting outpatient facility services
• Participate in quality assurance reviews and educational initiatives

Qualifications

• Minimum 3 years of outpatient facility coding experience required
• Experience assigning hospital outpatient facility E\&M levels required or strongly preferred
• Strong knowledge of:
• Hospital outpatient facility coding
• Facility E\&M leveling methodologies
• CPT and HCPCS coding guidelines
• ICD-10-CM diagnosis coding
• Modifier assignment and outpatient reimbursement methodologies
• CMS and payer regulatory requirements
• Charge capture workflows and documentation review
• Experience coding one or more of the following preferred:
• Hospital-based clinics
• Multi-specialty outpatient clinics
• Observation services
• Same-day surgery (SDS)
• Emergency Department
• Ancillary services
• Familiarity with Epic or other EMR systems preferred
• Strong attention to detail and critical thinking skills
• Ability to work independently in a remote production environment
• Excellent communication and organizational skills

Required Credentials

One or more of the following credentials required:

• AHIMA Certified Coding Specialist (CCS)
• AHIMA Registered Health Information Administrator (RHIA)
• AHIMA Registered Health Information Technician (RHIT)
• AAPC Certified Professional Coder (CPC)

Preferred Experience

• Facility outpatient coding
• Hospital outpatient reimbursement methodologies
• Medical necessity and charge review processes
• Denial resolution and edit work queues
• Remote coding production environments

Schedule \& Work Environment

• Remote position
• Full-time and contract opportunities available
• Flexible scheduling opportunities may be available based on client needs

Why Join Ocean Health Executives?

Ocean Health Executives is committed to delivering high-quality coding and consulting services through experienced, certified professionals. We foster a collaborative, compliance-focused environment that supports professional growth, coding excellence, and operational innovation across the healthcare industry.

Pay: $27\.00 per hour

Benefits:

• Flexible schedule

Experience:

• coding: 3 years (Preferred)

License/Certification:

• CCS (Preferred)
• RHIT (Preferred)
• CPC (Preferred)

Work Location: Remote