Professional Coder

Albany Medical Center•Albany, NY

2d•$59,066 - $88,599•Remote

About The Position

The Remote Professional Coder reviews, analyzes, and validates CPT and ICD-10 diagnosis codes, HCPCS, modifiers, and charges applied by providers to ensure compliance with federal and state regulations and insurance carrier guidelines. The role performs accurate and compliant professional coding and supports coding quality, denial research, audits, application testing, and provider documentation accuracy. This position is remote and is assigned to the Health Information Management department on the day shift. The position requires maintaining knowledge of insurance products, policies, procedures, and applicable state and federal mandates and legislation related to coding and documentation. The coder is expected to meet established productivity and quality standards, participate in assigned meetings, and pursue professional development. The role may involve access to sensitive information, including HIPAA-protected health information, which must be accessed, used, and disclosed only as necessary and protected from unauthorized access or modification.

Requirements

High school diploma or GED required.
Coding credential in good standing through AHIMA or AAPC, such as CPC, CCA, CCS, COC, RHIT, or RHIA, required.
Working knowledge and experience with provider professional fee coding and charge processing.
Computer experience in a Windows environment, with proficiency in Microsoft Word and Excel.
Excellent verbal and written communication skills, with high proficiency.

Nice To Haves

One to three years of experience in provider professional fee coding preferred.
Equivalent combinations of relevant education and experience may be substituted as appropriate.

Responsibilities

Review, analyze, and validate CPT, ICD-10 diagnosis codes, HCPCS, modifiers, and provider-applied charges for compliance with applicable regulations and insurance carrier guidelines.
Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.
Apply knowledge of National Correct Coding Initiative (NCCI) edits and relative value units as appropriate.
Meet established productivity and quality standards.
Review denials, research them, and respond appropriately and promptly.
Perform audits as determined by management.
Assist with all levels of application testing for identified coding workflows as needed.
Attend and contribute to PCO staff meetings, department meetings, and other assigned meetings.
Participate in professional development activities such as webinars, workshops, and conferences when appropriate.
Work effectively with people from different disciplines and with varying levels of business and technical expertise.
Remain knowledgeable about insurance products, including managed care, Medicaid, and Medicare; related policies and procedures; and state and federal coding and documentation mandates and legislation.
Interact with providers and their staff to support accurate and specific documentation and procedural and diagnostic coding.
Protect sensitive information by limiting access, use, and disclosure to the minimum necessary and taking reasonable steps to prevent unauthorized access or modification.
Perform other duties as assigned.