Outpatient Coding Specialist – Surgery

The Outpatient Coding Specialist – Surgery supports Lifepoint Health’s revenue cycle operations by assigning diagnosis and procedure codes for outpatient episodes of care, including same-day surgery, emergency department, outpatient clinic, observation, specialty clinic, and other hospital-based encounters.

This role requires strong knowledge of ICD-10-CM, CPT, HCPCS, CMS billing requirements, outpatient payment systems, coding guidelines, and medical necessity rules. The coding specialist reviews clinical documentation, resolves questionable records, submits physician queries when clarification is needed, and ensures compliance with AHIMA coding standards, hospital policy, and LifePoint Health Support Center procedures.

### Key Responsibilities

* Assign ICD-10-CM diagnosis codes
* Assign CPT and HCPCS procedure codes
* Code outpatient surgery and hospital encounters
* Review documentation for accuracy and completeness
* Resolve questionable documentation issues
* Submit physician queries when clarification is needed
* Apply CMS coding and billing requirements
* Follow AHIMA Standards of Ethical Coding
* Maintain 95% coding accuracy standards
* Meet assigned productivity goals
* Review APC, OPPS, NCCI, LCD, and NCD guidelines
* Verify, edit, or enter charges when needed
* Attend coding webinars and educational sessions
* Maintain coding credentials and education hours
* Support compliance reviews and department workflows
* Assist with coder training or review when assigned

### Requirements

* Knowledge of ICD-10-CM coding
* Knowledge of CPT and HCPCS coding
* Understanding of CMS billing requirements
* Ability to review and interpret clinical documentation
* Strong attention to detail
* Ability to work independently in a remote environment
* Knowledge of coding compliance standards
* Ability to meet quality and productivity standards
* Ability to maintain confidentiality and protect patient privacy

### Preferred Qualifications

* Associate Degree in a health-related field
* 1+ year outpatient coding experience
* Acute care hospital coding experience
* CCA certification
* CPC certification
* CCS certification
* RHIT certification
* Surgical coding experience
* OPPS and APC knowledge
* NCCI guideline knowledge
* LCD and NCD medical necessity knowledge

### Benefits

* Medical insurance
* Dental insurance
* Vision insurance
* Paid time off
* Paid family leave
* Life insurance
* Accident insurance
* Critical illness insurance
* Hospital indemnity insurance
* Short-term disability insurance
* Long-term disability insurance
* Tuition assistance
* Certification tuition assistance
* Loan assistance
* 401(k) with company match
* Wellness programs
* Virtual care support
* Mental health services
* Discount programs
* Career advancement opportunities

### Phone Level Breakdown

* Coding review: High
* Documentation review: High
* Physician queries: Low to Moderate
* Internal communication: Low
* Patient interaction: None
* Call center activity: None

### Best Fit For

Candidates with experience in outpatient coding, surgical coding, medical coding, ICD-10-CM, CPT coding, HCPCS coding, hospital billing, HIM, revenue cycle coding, physician documentation review, and coding compliance.