Outpatient Coder

Title: Outpatient Coder Reports to: Director of Revenue Integrity Classification: Individual Contributor Location: Boston, Hybrid Job description revision number and date: V 2.0; 5.11.2026 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Outpatient Coder will be a part of an emerging coding team under the billing and credentialing service that performs coding review for FQHCs. The coder reports to the Director of Revenue Integrity and is responsible for reviewing ambulatory medical records for multi‑specialty provider organizations to ensure billed codes are accurately supported by clinical documentation. The coder also interprets medical record data into language that payers can interpret to process physician charges, ensuring coding is compliant with all guidelines. Responsibilities Assigns appropriate diagnosis codes (ICD‑10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other information. Ensures all coding is completed in a timely manner to meet billing deadlines. Assists in resolving incomplete and/or missing documentation to expedite billing. Communicates with healthcare providers to clarify coding questions and concerns. Performs claim edit corrections and denial reviews related to coding errors. Identifies coding or documentation trends that may pose a risk to revenue and reports such trends to management. Stays abreast of coding and documentation guidelines, compliance policies, annual coding updates, payer policies, and industry changes. Performs all other duties as assigned. Required Skills Knowledge of ICD‑CM (current edition), CPT, HCPCS coding systems, and CCI edits. Knowledge of third‑party payer requirements, federal and state guidelines, and regulations on medical coding and billing. Knowledge of current ICD‑10‑CM and CPT/HCPCS Official Guidelines for Coding and Reporting. Knowledge of medical records content and management. Working knowledge of the EMR through experience or education. Medical terminology. Knowledge of laws and regulations about health information and patient confidentiality. Proficient in Microsoft Office applications such as Excel, Word, and PowerPoint. Demonstrates flexibility with respect to changing end‑user business needs. Good interpersonal and communication skills and demonstrates professionalism when working with team members, management, and other staff. Ability and willingness to take ownership of work activities, ensuring they are completed accurately, efficiently, and timely. Ability and willingness to learn new software and systems. Ability to determine a problem’s cause, develop a course of action, and prevent recurrence. Ability to persevere in difficult situations and overcome obstacles. Must be able to remain in a stationary position 50‑75% of the time. Desired Other Skills Familiarity with the MassHealth ACO program. Familiarity with Federally Qualified Health Centers. Experience with anti‑racism activities, and/or lived experience with racism is highly preferred. Qualifications High School Diploma or equivalent required. CPC Certification required. 3‑5 years of CPT/HCPCS outpatient coding experience, preferably in a multi‑specialty facility. Prior Epic experience highly preferred. In compliance with Infection Control practices per Mass.gov recommendations, all employees must be vaccinated consistent with applicable law. #J-18808-Ljbffr