Charge Entry/Certified Professional Coder (CPC)

Jax Spine & Pain Centers • Jacksonville, FL

1d

About The Position

The Certified Professional Coder (CPC) is responsible for accurately reviewing, abstracting, coding, and validating charges for professional and facility services at a large multi-site pain management practice and Ambulatory Surgery Center (ASC). The role ensures coding complies with federal and state regulations, payer guidelines, National Correct Coding Initiative (NCCI) edits, and organizational policies. The coder reviews provider documentation and assigns CPT®, HCPCS, and ICD-10-CM codes for office visits, interventional pain procedures, ASC procedures, imaging guidance, and related ancillary services. The CPC also advises physicians, advanced practice providers, clinical staff, and revenue cycle teams on documentation and coding requirements.

The position includes coding and documentation review, pain management procedure coding, ASC facility coding, compliance and quality assurance, provider education, and revenue cycle collaboration. The coder reviews operative and clinical documentation, validates medical necessity and diagnosis-to-procedure linkage, resolves coding edits and denials, participates in audits, supports payer reviews and appeals, and helps improve documentation and revenue cycle processes while maintaining compliance.

Requirements

• Current AAPC Certified Professional Coder (CPC) certification.
• High school diploma or equivalent.
• At least 3 years of professional medical coding experience.
• Experience coding surgical and interventional pain procedures.
• Strong understanding of CPT, ICD-10-CM, and HCPCS Level II coding.
• Strong understanding of modifier assignment, NCCI edits, CMS regulations, and medical necessity requirements.
• Experience with electronic medical record (EMR/EHR) systems and practice management software.
• Proficiency with Microsoft Office Suite.

Nice To Haves

• At least 2 years of pain management coding experience.
• Certified Professional Medical Auditor (CPMA) certification.
• Certified Outpatient Coder (COC) certification.
• Certified Ambulatory Surgery Center Coder (CASCC) certification.
• Associate degree in Health Information Management, Healthcare Administration, or a related field.
• ASC facility coding experience.
• Multi-specialty surgical coding experience.

Responsibilities

• Review physician, advanced practice provider, and ASC operative documentation for completeness and coding accuracy.
• Assign ICD-10-CM, CPT, and HCPCS codes for pain management services and procedures in accordance with official coding guidelines and supporting documentation.
• Apply payer-specific billing requirements and modifier usage, and review Evaluation & Management services using current CMS and AMA guidelines.
• Audit and code ASC operative reports and facility documentation; assign appropriate ASC procedure and revenue codes.
• Verify medical necessity requirements and diagnosis-to-procedure linkage.
• Correct coding errors and identify documentation deficiencies before claim submission.
• Review and resolve coding edits, claim rejections, and coding-related denials.
• Code pain management procedures, including injections, nerve blocks, radiofrequency ablation, spinal cord stimulator procedures, intrathecal pain pump procedures, kyphoplasty, vertebroplasty, and fluoroscopic or ultrasound guidance.
• Ensure facility coding supports ASC claim submission and reimbursement, and maintain knowledge of Medicare ASC payment methodologies and commercial payer requirements.
• Collaborate with ASC leadership on documentation and coding opportunities.
• Maintain organizational coding accuracy standards and participate in routine internal coding audits.
• Assist with payer audits and review requests, including RAC, CERT, UPIC, and commercial payer reviews.
• Identify compliance concerns and report findings to leadership.
• Stay current on coding changes, regulations, and payer updates.
• Educate physicians and advanced practice providers about coding, documentation, and reimbursement requirements.
• Participate in provider documentation improvement initiatives and provide feedback on coding trends, audit findings, and documentation gaps.
• Work with Charge Entry, Billing, Accounts Receivable, and Credentialing teams.
• Assist with coding-related appeals and denial management.
• Support revenue optimization initiatives while maintaining compliance.
• Participate in implementation and optimization of EHR and practice management systems.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED