Physician Coder, Sr

WakeMed Health & Hospitals • Raleigh, NC

6h

About The Position

Serves as an advanced member of the Physician Coding team responsible for advanced professional coding audits, complex coding issue resolution, coder and provider education, and ensuring compliance with ICD 10 CM, CPT, HCPCS, and payer specific policies. This role functions as a key liaison with Corporate Compliance, Revenue Integrity, Patient Access, Case Management, and clinical departments for all physician coding related functions. Supports pre-admission authorization accuracy by reviewing documentation, provider intent, and planned procedures to confirm correct CPT code selection prior to authorization submission. This includes coordinating with pre-admission nurses, surgical scheduling, case management, and physician practices to ensure authorized CPT codes accurately reflect the services planned. Operates with a high degree of independence and professionalism and is expected to demonstrate advanced clinical knowledge, analytical skill, and the ability to manage sensitive and confidential information. Supports departmental projects, workflow optimization, and mentorship of physician coding staff.

Requirements

• Certified Professional Coder Or Certified Coding Specialist- Physician Or Registered Health Information Technician Or Registered Health Information Administrator Required
• High School Diploma or Equivalent Required
• 5 Years Coding Required

Nice To Haves

• Associate's Degree Preferred

Responsibilities

• Advanced professional coding audits
• Complex coding issue resolution
• Coder and provider education
• Ensuring compliance with ICD 10 CM, CPT, HCPCS, and payer specific policies
• Liaison with Corporate Compliance, Revenue Integrity, Patient Access, Case Management, and clinical departments
• Support pre-admission authorization accuracy by reviewing documentation, provider intent, and planned procedures to confirm correct CPT code selection prior to authorization submission
• Coordinate with pre-admission nurses, surgical scheduling, case management, and physician practices to ensure authorized CPT codes accurately reflect the services planned
• Support departmental projects
• Workflow optimization
• Mentorship of physician coding staff

What This Job Offers

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