Job Details

Must-Haves:

• Epic Experience
• 4-5+ years of medical coding
• AAPC Certification
• Freestanding clinic / office, outpatient center experience
• Infusion coding experience

Plusses

• Incident TO billing experience

Day to Day:

• Review outpatient provider and nursing documentation for infusion services and E/M encounters.
• Assign accurate CPT, HCPCS, and ICD-10-CM codes for outpatient infusion, injection, hydration, and clinic visits.
• Apply correct time-based infusion coding (initial, subsequent, concurrent) and appropriate drug J-codes.
• Determine appropriate E/M levels using medical decision-making or time-based guidelines.
• Ensure correct use of modifiers (e.g., -25) when billing E/M services with infusion procedures.
• Validate coding against CMS outpatient guidelines, payer policies, and NCCI edits.
• Identify documentation gaps and submit provider queries as needed.
• Partner with billing and revenue cycle teams to resolve outpatient claim denials and appeals.
• Maintain productivity and accuracy standards in a high-volume outpatient setting.