Lead Certified Outpatient Hospital​/Facility Coding Specialist

• Review outpatient medical record documentation to identify diagnoses and procedures requiring code assignment
• Accurately assign ICD-10-CM, modifiers, and HCPCS codes for reimbursement, research, and regulatory compliance
• Review records for diagnosis and procedure specificity and appropriate reimbursement
• Query physicians when documentation is inadequate, ambiguous, unclear, or coding assignments are not straightforward
• Monitor coding and reimbursement reporting guidelines and escalate concerns to the manager
• Maintain 92%–95% ICD-10-CM and/or HCPCS coding accuracy while meeting productivity standards and minimizing abstracting errors
• Mentor and train newly hired Coders and provide ongoing Coding staff training
• Assist the Coding Manager with special coding assignments and unbilled issue resolution
• Serve as a resource for coding-related questions
• Follow AHIMA Standards of Ethical Coding and official coding guidelines
• Ensure safe care and comply with Memorial Hermann policies, procedures, and standards
• Support department goals and serve as a preceptor, mentor, and resource to less experienced staff
• Model Memorial Hermann service standards and provide safe, caring, personalized, and efficient experiences
• Perform other duties as assigned

• High School Diploma or GED required
• Associate degree in Health Information Management or any Healthcare Related Field preferred
• RHIT, RHIA, or relevant coding certification(s) from AHIMA or AAPC required
• Six (6) years of hospital outpatient or ambulatory coding experience
• Experience coding in a level 1 trauma facility/academic teaching facility preferred
• Effective oral and written communication skills
• Strong knowledge of ICD-10-CM and/or CPT coding
• Analytical skills to interpret health-record data and assign appropriate codes
• Strong knowledge of human anatomy, physiology, medical terminology, and surgical terminology
• Critical thinking, good judgment, and decision-making skills
• Knowledge of coding compliance policies, official coding guidelines, regulatory requirements, and internal coding policies and procedures
• Proficiency navigating a Windows-based application environment

Demonstrates expertise in ICD-10-CM and HCPCS coding, ensuring compliance with regulatory standards while maintaining high accuracy rates. Provides mentorship and training to coding staff, fostering a collaborative and efficient coding environment.

• ICD-10-CM Coding
• HCPCS Coding
• Coding Certification (RHIT, RHIA)
• Hospital Outpatient Coding Experience
• Analytical Skills

• ICD-10-CM Coding
• HCPCS Coding
• CPT Coding
• Coding Compliance Policies
• Health-Record Data Interpretation
• Human Anatomy Knowledge
• Medical Terminology
• Surgical Terminology
• Decision-Making Skills
• Productivity Standards

• Effective Communication Skills
• Critical Thinking
• Good Judgment

• RHIT
• RHIA
• Coding Certification from AHIMA or AAPC

• Outpatient Medical Record Documentation
• Reimbursement
• Regulatory Compliance
• Coding Guidelines
• Mentorship
• Ethical Coding Standards

• Windows-Based Application Environment