Professional Coder

This is a fully remote position, open to applicants in United States.

📋 Description

• Accurately review and assign CPT, HCPCS, and ICD-10-CM codes for professional claims.

• Implement official AMA and CMS coding standards and regulations.

• Examine procedure documentation to assign ICD-10-CM diagnosis codes, CPT-4 codes, and modifiers.

• Ensure proper coding of evaluation and management services.

• Review documentation for operating room and complex procedure-room cases.

• Validate the ICD-10-CM diagnosis codes selected by providers.

• Analyze provider documentation to ensure appropriate provider-assigned E&M codes.

• Meet or surpass departmental standards for accuracy and productivity.

• Ensure adherence to national coding guidelines and Capital Health policies.

• Review CCI edits, MUE edits, and LCD and NCD coverage prior to chart finalization.

• Identify and escalate documentation gaps or inconsistencies when clarification is necessary.

• Collaborate with billing, charge review, and revenue integrity teams.

• Address professional coding pre-bill edits in a timely manner.

• Act as a subject matter expert in professional coding.

• Promote teamwork and collaboration within the department.

• Perform additional duties as assigned.

⛳️ Requirements

• High school diploma or equivalent qualification.

• Required certifications include Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P).

• An associate's degree in health information management is preferred.

• A minimum of two years' experience in a physician coding role is preferred.

• Experience with ICD-10-CM, CPT-4, and HCPCS coding is preferred.

• At least one year of surgical coding experience is preferred.

• Excellent verbal and written communication abilities.

• Strong understanding of surgical coding guidelines.

• Knowledge of pathophysiology and disease processes.

• Certification in Physician coding and Training.

• Proficient in Microsoft applications including Outlook, Word, Excel, and PowerPoint.

• Familiarity with Medical Terminology, Anatomy and Physiology, or Pathophysiology.

• Ability to navigate multiple EMR systems effectively.

• Capacity to work collaboratively with others and also independently.

• Accurate near vision, far vision, minimal color discrimination, precise depth perception, and hearing capabilities.

🏝️ Benefits

• Medical Plan.

• Prescription drug coverage & In-House Employee Pharmacy.

• Dental Plan.

• Vision Plan.

• Flexible Spending Account (FSA).

• Healthcare FSA.

• Dependent Care FSA.

• Retirement Savings and Investment Plan.

• Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance.

• Supplemental Group Term Life & Accidental Death & Dismemberment Insurance.

• Long Term Disability (LTD) benefits.

• Short Term Disability (STD) benefits.

• Employee Assistance Program.

• Commuter Transit.

• Commuter Parking.

• Supplemental Life Insurance.

• Voluntary Life Spouse coverage.

• Voluntary Life Employee coverage.

• Voluntary Life Child coverage.

• Voluntary Legal Services.

• Voluntary Accident, Critical Illness and Hospital Indemnity Insurance.

• Voluntary Identity Theft Insurance.

• Voluntary Pet Insurance.

• Paid Time-Off Program.