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Outpatient Coder 4 Certified / PB Coding

Requisition ID:


Business Unit:

Hartford HealthCare Corp.


Newington, CT

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Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details:

Work where every moment matters.

Every day, almost 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.

The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.


Leads outpatient and professional coding team as assigned and backs up manager in their absence. Trains and mentors new and existing coders.

Reviews and investigates issues sent to OP or Professional Coding team and collaboration with coders and other departments to resolve.

Codes and/or charges all types of outpatient or professional accounts to assist with backlog as reviewing outpatient clinical documentation and diagnostic results.  Extracts data and assigns alpha numeric codes for billing, internal and external statistical reporting, research, regulatory compliance and reimbursement.



  1. Codes accounts to assist with backlog as necessary
  2. Applies knowledge of anatomy and physiology, clinical disease processes, pharmacology, and diagnostic and procedural terminology to determine the appropriate assignment of diagnosis and procedure codes.
  3. Analyzes medical records, interprets documentation and assigns proper International Classification of Diseases, Tenth Edition Clinical Modification (ICD‑10‑CM), Current Procedural Terminology/HealthCare Common Procedure Coding System (CPT/HCPCS), modifiers, and Evaluation & Management codes utilizing designated software to include Computer Assisted Coding (CAC) and/or encoder, coding manuals and other reference material as required.
  4. Enters charges for procedures that are not soft coded as instructed for certain patient types
  5. Adheres to all department coding/charging procedures, policies, guidelines and quality standards.
  6. Ability to code all outpatient or professional cases identified in Levels 1-3 and/or accounts related to their areas of responsibility.
  7. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association/American Association of Procedural Coders and adheres to official coding guidelines.

Issue Resolution

  1. Manage the OP or Professional coding and edit work queues.
  2. Works with coders and other department to resolve.
  3. Reviews and investigate other issues related to OP or professional coding and/or charging and communicates with coder and other departments to resolve.
  4. Completes review of denials.


  1. Collaborates with coders to resolve issues and provide guidance.
  2. Collaborates with other departments (Billing, Registration, Revenue Integrity, etc.) as required.
  3. Seeks clarification from physicians or other staff in cases where documentation is absent, ambiguous, or contradictory
  4. Makes corrections based on collaboration with clinician or designee.


  1. Leads coding teams as assigned
  2. Trains and mentors new coders to become acclimated to new environment, and understanding internal coding/charging policies and procedures.
  3. Trains and mentors coders who wish to progress to more specialize coding of the most complicated types of accounts.
  4. Advances the team by influencing desired H3W Leadership Behaviors
  5. Supports and participates in special projects and assignments.
  6. Backs up manager in absence
  7. Meet revenue cycle goals (Key Performance Indicators (KPIs)and Productivity Standards

This position reports to Outpatient or Professional Coding Manager.




Associate’s Degree or equivalent experience


Four years or more of progressive on-the-job experience in an acute care hospital or physician office setting

Licensure, Certification, Registration

  • CPC, CPCH, or CCS certification required and maintained thereafter.
  • Certified Interventional Radiology Cardiovascular Coder (CIRCC) certification

Knowledge, Skills and Ability Requirements:

Proficient Knowledge of:

  • ICD‑10-CM diagnostic and CPT/HCPCS procedure codes
  • Working knowledge of clinical information
  • Microsoft Office Products; Word, Excel
  • Encoder and/or CAC


  • Read, write and speak English proficiently.
  • Solid analytical capabilities.
  • Good organizational skills.
  • Proficiently read and interpret physician writing.

Ability to:

  • Function independently.
  • Handle multiple priorities.
  • Listen and acknowledge ideas and expressions of others attentively.
  • Converse clearly using appropriate verbal and body language.
  • Collaborate with others to achieve a common goal through mutual cooperation.
  • Influence others for positive and productive outcomes.
  • Utilize coding subject matter expertise to support Levels 1 - 3 coders and other projects.
  • Ability to work across the Hartford HealthCare System.

We take great care of careers.

With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.

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