Outpatient Coder

Outpatient Coder 3.6 3.6 out of 5 stars 1500 East Cedar Avenue, Flagstaff, AZ 86004 $44,200 a year - Full-time Native Americans for Community Action 8 reviews $44,200 a year - Full-time

ESSENTIAL DUTIES

• Assign accurate ICD-10 CM, CPT, and HCPCS Level II codes for outpatient and ancillary services, including primary care, behavioral health, preventive, telehealth, and audio-only services.
• Abstract all clinically relevant data from the EHR to support compliant charge creation in the practice management system.
• Apply current CMS, Medicaid, Medicare, and payer‑specific coding and billing guidelines, including National and Local Coverage Determinations (NCDs/LCDs)..
• Determine appropriate E/M levels using AMA CPT and CMS guidelines based on Medical Decision Making (MDM) and/or total time.
• Apply add‑on and complexity codes (e.g., G2211) when supported by documentation and payer policy.
• Review, validate, and finalize codes generated digital-assisted coding tools, when utilized.
• Escalate documentation gaps or discrepancies for clarification or correction.
• Perform charge entry and claim preparation for CMS‑1500 and UB‑04 electronic claims.
• Monitor, review, and resolve claim edits, rejections, and denials in coordination with billing staff.
• Support denial prevention through proactive coding accuracy and documentation review.
• Participate in internal audits, quality improvement initiatives, and corrective action plans related to coding and billing.
• Stay current on CMS rule changes, CPT updates, payer policy revisions, and regulatory guidance.
• Work collaboratively with providers, clinical staff, billing team, and supervisors to support accurate documentation and coding.
• Performs other duties as assigned.

MINIMUM REQUIREMENTS

Associate degree in medical field. Two (2) years' experience as a medical coder; obtain the American Academy of Professional Coders' credential or Certified Professional Coder (CPC). Or equivalent combination of education and experience sufficient to successfully perform the essential duties of this position. Working knowledge of medical billing, ICD-10 proficiency, CPT-4, CPT-2, HCPCS codes, and claim filing guidelines with Medicaid, Medicare, and major third-party payers. Must be current with required immunization per the NACA HR Policies and Procedures and Infection Control Policy. This position is covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes. Level I Fingerprint Clearance Card. BLS Certification and HIPAA Certification. Possess a valid state Driver's License. Must pass a criminal background check in accordance with NACA Policy. Maintain required certifications.

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of ICD-10 CM, CPT, and HCPCS Level II codes for outpatient and ancillary services.
• Proficiency in E/M coding under current MDM‑based guidelines.
• Knowledge of CMS OPPS, MPFS, site‑neutral payment policies, and payer edits.
• Experience with EHR and practice management systems..
• Ability to maintain strict confidentiality and comply with HIPAA.
• Must complete and submit a NACA, Inc.

Employment Application, Letter of Interest, Resume, and Transcripts. Application can be obtained through website www.nacainc.org. Any questions, please contact Human Resources at (928) 526-2968. Employee exercises EEOC, Veterans, and Indian Preference in accordance with the Indian Preference Act. If you wish to exercise Indian preference and you are a registered member of a federally or state recognized tribe, attach a copy of tribal Certificate of Indian Blood (CIB).

Pay:

$44,200.00 per year

Benefits:

Dental insurance Employee assistance program Health insurance Health savings account Life insurance Retirement plan Vision insurance

Work Location:

In person