The posting
Job Description
We are seeking an experienced Facility Outpatient Coding Specialist to support a large academic university health system and Level I Trauma Center. This role is focused exclusively on outpatient coding edits and claim review activities, ensuring accurate code assignment, modifier usage, National Correct Coding Initiative (NCCI/CCI) compliance, and medical necessity validation across multiple outpatient specialties.
The ideal candidate will have strong outpatient edit experience, a thorough understanding of payer guidelines, and proficiency with both Cerner and 3M coding applications.
Key Responsibilities
- Review and resolve outpatient coding edits for facility-based services.
- Analyze and correct NCCI/CCI edits to ensure coding compliance and claim accuracy.
- Review and apply appropriate modifiers based on documentation and payer requirements.
- Validate and address medical necessity edits in accordance with CMS and payer guidelines.
- Collaborate with coding, compliance, revenue cycle, and clinical teams to resolve coding discrepancies.
- Maintain coding quality standards while meeting productivity and turnaround time expectations.
- Stay current with coding regulations, payer policies, and industry best practices.
- Support accurate reimbursement through compliant coding and edit resolution processes.
Required Qualifications
- Minimum 2 years of facility outpatient coding experience.
- Demonstrated experience working outpatient coding edits, including:NCCI/CCI edits Modifier review and application Medical necessity review
- Experience supporting multiple outpatient specialties.
- Strong understanding of CMS regulations, payer policies, and outpatient reimbursement methodologies.
- Experience using Cerner and 3M coding systems (required).
- Excellent analytical, problem-solving, and communication skills.
- Ability to work independently in a remote environment while maintaining quality and productivity standards.
Preferred Qualifications
- Certified coding credential such as:CPC CCS CCS-P RHIT RHIA
- Experience supporting academic medical centers or Level I Trauma Centers.
- Prior experience with outpatient facility claim editing and revenue integrity workflows.
Training & Schedule
- Initial Training: First week requires availability Monday through Friday, 8:00 AM to 4:00 PM MST.
- Post-Training Schedule: Flexible scheduling may be available based on business needs, performance, and management approval.
Work Environment
This is a remote position supporting a university-based health system and Level I Trauma Center. The role requires attention to detail, strong coding knowledge, and the ability to effectively manage outpatient coding edit workflows in a fast-paced healthcare environment.
Qualifications
Required Qualifications
- Minimum 2 years of facility outpatient coding experience.
- Demonstrated experience working outpatient coding edits, including:NCCI/CCI edits Modifier review and application Medical necessity review
- Experience supporting multiple outpatient specialties.
- Strong understanding of CMS regulations, payer policies, and outpatient reimbursement methodologies.
- Experience using Cerner and 3M coding systems (required).
- Excellent analytical, problem-solving, and communication skills.
- Ability to work independently in a remote environment while maintaining quality and productivity standards.
About Us
Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at [email protected].
