Job Description
Job Description
Day-to-Day Responsibilities• Review and code professional fee encounters using ICD-10-CM, CPT, and HCPCS guidelines.
• Assign accurate E/M levels, diagnoses, and procedure codes to ensure compliant reimbursement.
• Abstract key patient and encounter data for billing, regulatory, and reporting purposes.
• Audit medical records to ensure documentation supports services billed and identify documentation gaps.
• Communicate with physicians and providers to obtain coding and documentation clarifications.
• Review and resolve coding-related claim edits, including medical necessity and NCCI/CCI edits.
• Collaborate with billing and Accounts Receivable teams to resolve coding and reimbursement issues.
• Maintain quality and productivity standards while meeting a 95% coding accuracy requirement.
• Work within EMR, hospital information systems, and encoder software in a fully remote environment. Stay current on coding regulations, payer requirements, and continuing education requirements.
Required Skills & Experience
• 3+ years of Professional Fee (Pro-Fee) Coding experience. • Active coding certification through AAPC or AHIMA. • Active RHIT, RHIA, CPC, COC, CCS-P, CCS, CEDC, or equivalent coding credential. • Experience coding clinic visits/professional services. • Strong experience with Evaluation & Management (E/M) coding, diagnosis coding, injections, and procedure coding. • Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and coding compliance guidelines. • Experience with Cerner EMR. • Experience working remotely. • Proficiency in Microsoft Outlook, Excel, and Teams. Strong communication, organization, and multitasking skills. Nice to Have Skills & Experience • Emergency Department (ED) coding experience. • Multi-specialty Pro-Fee coding background. • Experience with regulatory reporting and data abstraction. • Prior hospital or health system coding experience. • Experience partnering with AR/billing teams on claim resolution. • History of exceeding coding productivity and quality metrics. • Experience mentoring, training, or educating other coders. Additional AAPC or AHIMA certifications beyond minimum requirements.
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