Outpatient Coding Analyst, Full Time, Days

About the Role:

The Outpatient Coding Analyst plays a critical role in ensuring the accuracy and compliance of medical coding for outpatient services at UH WCMC and WCMCH. This position is responsible for reviewing clinical documentation and assigning appropriate diagnosis and procedure codes in accordance with established coding guidelines and regulations. The analyst collaborates closely with healthcare providers, billing teams, and compliance officers to optimize coding accuracy, support revenue cycle management, and reduce claim denials. By maintaining up-to-date knowledge of coding standards and healthcare regulations, the analyst helps to ensure that outpatient services are properly documented and reimbursed. Ultimately, this role contributes to the financial integrity and operational efficiency of the healthcare organization while supporting high-quality patient care documentation.

Minimum Qualifications:

• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) credential.
• Minimum of 2 years of experience in outpatient medical coding.
• Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
• Familiarity with outpatient clinical documentation and healthcare reimbursement processes.
• Proficiency with electronic health record (EHR) systems and coding software.

Preferred Qualifications:

• Experience working in a large academic medical center or hospital outpatient setting.
• Knowledge of Medicare and Medicaid outpatient billing regulations.
• Additional certifications such as Certified Outpatient Coder (COC) or Certified Inpatient Coder (CIC).
• Experience with data analysis and reporting tools related to coding and billing.
• Strong communication skills for effective collaboration with multidisciplinary teams.

Responsibilities:

• Review outpatient clinical documentation to assign accurate ICD-10-CM, CPT, and HCPCS codes.
• Ensure coding compliance with federal, state, and payer-specific regulations and guidelines.
• Collaborate with physicians and clinical staff to clarify documentation and resolve coding discrepancies.
• Conduct regular audits of coded data to identify trends, errors, and opportunities for improvement.
• Provide education and feedback to clinical and administrative staff regarding coding best practices and regulatory changes.
• Support the revenue cycle by working with billing and claims teams to address coding-related denials and inquiries.
• Maintain current knowledge of coding updates, industry standards, and healthcare regulations through continuous education.

Skills:

The required skills enable the Outpatient Coding Analyst to accurately interpret clinical documentation and apply the correct codes, which is essential for proper billing and compliance. Proficiency with coding systems and EHR software allows the analyst to efficiently process large volumes of outpatient records while maintaining accuracy. Strong analytical skills are used daily to audit coding data, identify discrepancies, and implement corrective actions. Communication skills facilitate collaboration with healthcare providers and administrative teams to clarify documentation and resolve coding issues. Preferred skills such as knowledge of payer regulations and data analysis enhance the analyst's ability to optimize revenue cycle performance and support organizational goals.