Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.
Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.
Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.
Join our team as the expert you are now and create your future.
Huron partners with healthcare organizations to drive growth, improve performance, and strengthen innovation. We help clients adapt to rapid industry change by optimizing operations, enhancing clinical outcomes, improving consumer experience, and increasing engagement across the enterprise.
The Coder – Outpatient Surgery & Observation provides technical expertise in reviewing physician/provider documentation for outpatient surgery, observation, and potentially ambulatory clinic encounters (e.g., infusion, wound care, urology, cardiology, endoscopy). This role determines accurate diagnoses, procedures, APCs, modifiers, and identifies NCCI and LCD/NCD edits to ensure proper reimbursement.
- Utilize encoder software and online tools to assign ICD-CM, CPT/HCPCS, and APC codes; resolve system edits and support timely claims submission.
- Apply coding guidelines from CMS, AHA Coding Clinic, AMA CPT, and AHIMA Standards of Ethical Coding; adhere to all coding procedures.
- Review patient records and related systems to determine all required codes, modifiers, and edits affecting reimbursement.
- Interpret bundling/unbundling rules (NCCI), LCD/NCD edits, and payer policies.
- Work internal/external outpatient claim edits; route non-coding edits to appropriate teams.
- Meet organization standards for coding quality and productivity.
- Use compliant query practices when documentation requires clarification; track missing documentation using EMR tools.
- Collaborate with HIM, Revenue Integrity, Billing, and PFS on claims, denials, and appeals.
- Maintain CEUs and current knowledge of changes in outpatient coding regulations.
- Identify workflow or EMR issues impacting coding; escalate documentation or ethical concerns when needed.
- Maintain knowledge of relevant laws, regulations, and ethical standards.
- May abstract additional data; perform other duties as assigned.
Core Qualifications
- Permanent U.S. work authorization required.
- CCS, CCA or COC Certifications
- Three (3) years of current acute care outpatient surgery and observation coding experience required.
- Extensive knowledge of medical terminology, anatomy and physiology, diagnostic/procedural coding, APC assignment, NCCI edits, and LCD/NCD edits.
- Experience using encoder/grouping software and CAC preferred.
- Ability to use standard computer applications, email, internet, and web-based tools.
- Strong oral/written communication; able to work with diverse groups.
- Ability to research, analyze, and integrate information from multiple sources.
- Strong critical thinking, problem-solving, organization, and customer service skills; meets productivity requirements.
- Adaptable, flexible, and able to prioritize in a virtual environment with minimal supervision.
- Demonstrates integrity, professionalism, and alignment with Huron’s mission, vision, and values
- Encoder experience (3M/Solventum, Encoder Pro, Codify) preferred
- Epic, Cerner, and Meditech experience preferred.
Additional Job Description
The estimated pay range for this job is $26.44 - $36.06 per hour. The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes and required travel. This job is also eligible to participate in Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The pay range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.
Position Level
Analyst
Country
United States of America
