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Coding Consultant Outpatient – PRN – Billing/Edits/Denials

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Remote from
USA
Salary
USD 20–35 / hour
Employment
Full Time
Experience
Senior
Published
Apply before
2 Dec 2026
Listing views
47
Application actions
3
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AI Summary

The role, at a glance.

Datavant is seeking a credentialed outpatient coding consultant to review hospital records, assign diagnosis and procedure codes, and resolve claim-edit and denial-related issues. The role requires strong expertise in hospital billing claim edits, outpatient coding workflows, APC assignment, and coding compliance. Candidates need an AHIMA or AAPC credential, relevant hospital or consulting experience, and the ability to meet 95% coding and APC accuracy targets. This is a fully remote US role with a flexible schedule and ongoing credentialing and education requirements.

Role DNA

A quick view of the complexity, pace, ownership and collaboration implied by the job description.

Job Complexity

4/5
EasyHard

Pace & Pressure

4/5
RelaxedFast-paced

Autonomy Level

4/5
GuidedFull ownership

Communication Load

4/5
IndependentCollaborative
AI insightThe role requires certified outpatient coding expertise, accurate interpretation of clinical documentation, and specialized knowledge of hospital billing edits and reimbursement rules. High accuracy and productivity standards add meaningful complexity and pace.

Salary analysis

Estimated compensation compared with the broader US market for similar roles.

Estimated job median (per hour)Market rate
$27.50
US market range (per hour)$24–$38
AI insightThe hourly pay period is inferred from the job context; it was not explicitly stated by the employer. The employer explicitly lists an estimated base pay range of $20–$35 USD per hour, with a midpoint of $27.50 per hour. Estimated US market pay for an experienced, credentialed outpatient hospital coding consultant is approximately $24–$38 USD per hour; actual pay may vary by credentials, claim-edit specialization, productivity expectations, and location.

Core skills

Skills and capabilities most closely associated with this opportunity.

Sample interview questions
How do you approach an outpatient claim edit that may affect APC assignment or reimbursement?

I first review the complete clinical documentation and applicable coding guidelines, then validate diagnosis, procedure, modifier, and charge information. I identify the root cause of the edit, correct or clarify documentation when appropriate, and ensure the final coding supports accurate APC assignment and compliant reimbursement.

What practices help you consistently meet a 95% coding accuracy target?

I use a disciplined review process, stay current on official coding guidance, and verify high-risk elements such as modifiers, sequencing, medical necessity, and discharge disposition. I also track recurring errors and use audit feedback to improve my workflow and prevent repeat issues.

Describe your experience with hospital billing claim edits.

My experience includes reviewing outpatient hospital claims for coding, charge, modifier, and documentation issues before submission or during denial follow-up. I prioritize edits by financial and compliance impact, research the applicable guidance, and document resolutions clearly for billing and clinical stakeholders.

How do you stay effective while working independently in a remote coding role?

I maintain a structured daily workflow with productivity goals, protected time for complex record review, and clear tracking of outstanding questions. I communicate proactively through approved channels, document decisions thoroughly, and escalate clinical or reimbursement concerns promptly when collaboration is needed.

How do you maintain your AHIMA or AAPC credentials and keep current with coding changes?

I actively track CEUs throughout the year, attend relevant education sessions and in-services, and review annual updates to coding guidelines and payer requirements. I apply new guidance in practice through targeted learning, reference tools, and discussions with coding leadership when clarification is needed.

This analysis is generated from the job description. Salary estimates, role characteristics and sample answers are guidance, not employer-provided facts.
Opportunity details

About this role.

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem – including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health.

By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare.

We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! We are in need of an Outpatient Claim Edits coder. A minimum of 3 years of experience with Hospital Billing(HB) Claim edits is a requirement. Experience with Parallon, Cerner, and Optum would benefit a candidate in this role. Additionally, experience with use of Microsoft Office suite, primarily excel is a plus.

What You Will Do:

  • Review medical records and assign accurate codes for diagnoses and procedures.
  • Assign and sequence codes accurately based on medical record documentation.
  • Assign the appropriate discharge disposition.
  • Abstract and enter the coded data for hospital statistical and reporting requirements.
  • Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution.
  • Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards.
  • Be responsible for tracking continuing education credits to maintain professional credentials.
  • Attend Datavant Health sponsored education meetings/in-services.
  • Demonstrate initiative and judgment in the performance of job responsibilities.
  • Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues.
  • Function in a professional, efficient, and positive manner.
  • Adhere to the American Health Information Management Association’s code of ethics.
  • Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn.
  • Handle a high complexity of work function and decision-making.
  • Possess strong organizational and teamwork skills.
  • Comply with all HIM Division Policies.

What You Need to Succeed:

  • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC).
  • 2+ years of coding experience in a hospital and/or coding consulting role.
  • Proficiency with most or all of these coding specialties (Same Day Surgery, Observation, Injections/Infusions)
  • Proficiency with most or all of these coding specialties (Ancillary, Emergency Department, Injections/Infusions, E/M leveling)
  • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills.
  • Experience in computerized encoding and abstracting software.
  • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually
  • Experience in computerized encoding and abstracting software

What We Offer:

  • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays
  • Benefits for PRN employees: 401k savings plan w/match
  • Free CEUs every year
  • Stipend provided to assist with education and professional dues (AHIMA/AAPC)
  • Equipment: monitor, laptop, mouse, headset, and keyboard
  • Comprehensive training led by a credentialed professional coding manager
  • Exceptional service-style management and mentorship (we’re in this together!)

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

The estimated base pay range per hour for this role is:

$20—$35 USD

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

This job is not eligible for employment sponsorship.

Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren’t even able to see whether you’ve responded.) Responding is entirely optional and will not affect your application or hiring process in any way.

Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the ‘Interview Accommodation Request’ category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis.

For more information about how we collect and use your data, please review our Privacy Policy.

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