The Onyx Group - Medical Physician Coder

Tribe 513•Greenville, SC

2d•Onsite

About The Position

The Medical Physician Coder is responsible for reviewing provider documentation and accurately assigning diagnosis and procedure codes for physician (professional billing/PB) services. The coder ensures all coding is compliant with federal regulations, payer guidelines, and organizational policies to support accurate charge capture and clean claim submission. This role utilizes the Epic electronic health record and or E Clinical Works (eCW) and coding tools to code physician encounters and works with clearinghouse platforms such as Waystar and/or FinThrive to support claim validation and error resolution. The coder collaborates with revenue cycle and clinical teams to ensure documentation supports medical necessity and coding accuracy while maintaining established productivity and quality standards.

Requirements

Proficiency in Epic and/or eClinical Works (eCW)
Experience with Waystar and/or FinThrive clearinghouse platforms
Knowledge of ICD-10-CM, CPT, and HCPCS coding systems
Understanding of Evaluation & Management (E/M) coding
Familiarity with NCCI edits, LCDs, NCDs, and payer-specific policies
Knowledge of HIPAA and other regulatory requirements
Strong analytical and problem-solving skills
Excellent communication and collaboration abilities
Attention to detail and commitment to accuracy

Nice To Haves

Certified Professional Coder (CPC) or equivalent certification

Responsibilities

Review physician documentation and assign appropriate ICD-10-CM, CPT, and HCPCS codes for professional billing services in Epic in accordance with official coding guidelines.
Apply appropriate Evaluation & Management (E/M) levels, modifiers, and procedure codes based on provider documentation and payer requirements.
Ensure coding supports medical necessity and payer guidelines, including Medicare and commercial payer policies.
Perform coding validation and quality checks to ensure accuracy, completeness, and compliance with regulatory standards.
Identify documentation deficiencies and communicate with providers or clinical staff for clarification when necessary.
Work within Waystar and/or FinThrive clearinghouse platforms to support clean claim submission and resolve coding-related edits prior to claim transmission.
Maintain knowledge of National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCD), National Coverage Determinations (NCD), and payer-specific policies.
Collaborate with revenue cycle teams to resolve claim edits, coding discrepancies, and billing issues impacting reimbursement.
Utilize coding resources such as Epic coding tools, encoders, reference materials, and payer guidance to support accurate coding.
Maintain compliance with HIPAA, regulatory requirements, and organizational policies in all coding activities.
Participate in departmental meetings, training sessions, and continuing education to maintain coding competency and stay current with industry changes.
Maintain established coding productivity standards as defined by departmental leadership.
Achieve and maintain coding accuracy and quality benchmarks, typically measured through internal quality audits.
Ensure timely completion of assigned coding work queues to support efficient claim submission and revenue cycle operations.
Demonstrate attention to detail and consistent adherence to coding compliance standards and organizational policies.