Outpatient Coder

Title: Outpatient Coder Reports to: Director of Revenue Integrity Classification: Individual Contributor Location: Remote 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 multi-service organization 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 fulfill two primary business functions for the FQHCs we work with. First, we are an FQHC-led accountable care organization (ACO); second, we are a Management Services Organization (MSO) for FQHCs.

As an ACO, we negotiate value-based payor contracts on behalf of our FQHCs, hold and operate those contracts (including fulfilling many compliance, financial management, and population health management functions), and maximize the return to FQHCs of any incentive dollars earned. We are proud to be the market leader in the MassHealth ACO Program. We are the largest Medicaid ACO in Massachusetts, and we operate a variety of business offerings nationwide. As an MSO, we (along with our subsidiary companies, which are also FQHC-led non-profits) provide several financial, operational, and technological services to groups of FQHCs.

These services include Epic EHR licensing and implementation; pharmacy operations consulting as well as the building and direct operation of on-site retail pharmacies; billing and credentialing; employer-sponsored insurance; and others. We are a fast-growing, dynamic 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 that are part of the billing service. The Outpatient Coder will report to 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 the clinical documentation. The coder will also be responsible for interpreting medical record data into language that the payers can interpret in order to process physician charges, and ensuring that coding is compliant with all coding 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 in order to expedite billing • Communicates with healthcare providers to clarify coding questions and concerns • Performs Claim edit corrections and Denial reviews related to coding errors • Identify coding or documentation trends that may pose a risk to revenue stream and report…

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