Duties may include but are not limited to the following: Codes and abstracts, and reviews discharged outpatient medical records and physician professional services for a multi-specialty teaching facility using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM); International Classification of Diseases, Tenth Revision, Clinical Modification and Procedure Coding System (ICD-10-PCS); Current Procedural Terminology (CPT); Health care Common Procedure Coding System (HCPCS); Prospective Payment System (PPS); and/or Diagnosis-Related Group (DRG) assignments based on Prospective Payment System (PPS) and/or Ambulatory Payment Classification (APC) methodologies; including Evaluation and Management codes (E/M), procedure codes, modifiers, National and Local Correct Coding Initiatives (NCCI) edits; Examines and analyzes provider documentation and medical charts for completeness, accuracy, and relevancy in accordance with Federal and State regulations, ICD-10-CM Official Coding Guidelines and American Medical Association (AMA) guidelines; Identifies the need for additional clinical documentation and sends queries to physicians for clarification on diagnoses and procedures performed to assign and/or validate the diagnosis or procedure code(s); Conducts provider training and on-going education on billing guidelines and audits the work of non-facility coders; Assists the Clinical Documentation Improvement (CDI) team with education CPT/HCPCS codes, billing guidelines and charge capture Outpatient ancillary department clinical staff; Inputs completed patient data coding classification systems into the hospital's Information Management System in accordance with The Joint Commission (TJC) and the Corporate Integrity Agreement between VCMC and the Office of the Inspector General; May process fee-for-service physician claims and audit physician billing for contract compliance; Identifies coding trends or issues and assists in resolving them; Ensures codes meet payer-specific requirements and resolves denials; and. KNOWLEDGE, SKILLS, and ABILITIES: Thorough knowledge of: ICD-10-CM, ICD-10-PCS, CPT, HCPCS, PPS, DRG and APC systems; E/M and procedure codes, modifiers, and NCCI edits; anatomy, physiology, disease pathology, and medical terminology necessary to correctly code diagnoses, procedures, and services; and.