Charge Entry & Coding Specialist (PT)

Cardiovascular Associates of America

10d•Remote

About The Position

The Charge Entry & Coding Specialist is responsible for the accurate and timely entry of professional charges, validation of coding elements, and preparation of claims for submission to payers. This role ensures services provided are properly documented, coded, and billed in compliance with payer guidelines and regulatory requirements. The position works closely with clinical teams, coding resources, and revenue cycle leadership to support accurate charge capture, minimize billing edits and rejections, and maintain strong first-pass claim acceptance rates.

Requirements

High school diploma or equivalent required
Certified Professional Coder (CPC) certification required
Minimum of two (2) years of professional coding experience in a physician practice or healthcare revenue cycle environment required
Knowledge of medical billing processes and revenue cycle workflows
Strong understanding of CPT, HCPCS, ICD-10 coding structures and modifier usage
Demonstrated experience reviewing clinical documentation and applying accurate CPT, ICD-10, and modifier coding in accordance with payer and regulatory guidelines
Ability to interpret physician documentation and diagnostic reports to determine appropriate coding and charge capture
Experience resolving claim edits related to coding accuracy, medical necessity, and modifier usage prior to claim submission
Working knowledge of payer guidelines, NCCI edits, and medical necessity requirements affecting reimbursement

Nice To Haves

Associate degree in Health Information Management, Healthcare Administration, or related field preferred
Experience coding cardiology services strongly preferred, including diagnostic testing, E&M services, and cardiovascular procedures
Experience coding services performed in an Ambulatory Surgery Center (ASC) environment to include facility coding preferred
Experience with charge entry and claim preparation within a practice management system (AthenaOne, NextGen, eClinicalWorks, or similar) preferred
Familiarity with payer billing requirements, modifier usage, and claim edit resolution preferred

Responsibilities

Monitor assigned A/R work queues to ensure timely follow-up on outstanding claims.
Review unpaid claims and identify root causes of delayed reimbursement.
Prioritize accounts based on aging, payer requirements, and financial impact.
Document follow-up activity and claim status updates within the practice management system.
Escalate complex or high-value accounts as needed to leadership.
Enter professional/facility charges into the practice management system accurately and within established timelines.
Validate CPT, HCPCS, modifiers, and ICD-10 codes for completeness and accuracy prior to claim submission.
Confirm correct rendering provider, location, and place of service are applied to charges.
Review clinical documentation to ensure billed services are supported by the medical record.
Identify and escalate documentation or coding discrepancies to coding or clinical staff as needed.
Prepare and submit claims to payers in accordance with established billing schedules.
Review system edits and claim scrubbing alerts prior to claim submission.
Resolve claim edits, missing information, or data inconsistencies to prevent claim rejection.
Ensure claims meet payer requirements for medical necessity and coding guidelines.
Monitor charge lag and support timely claim generation.
Ensure charge capture and billing practices align with payer regulations and compliance standards.
Maintain accurate documentation of charge corrections or adjustments.
Support internal audits and compliance reviews as needed.
Identify opportunities for process improvement to reduce errors and improve claim acceptance rates.