Experienced Professional Coding Specialist
About The Position
Join a forward-thinking team where your expertise drives quality patient care! We are looking for a detail-oriented Professional Medical Coder to help streamline our charge review coding workflow for Adult and Pediatric Evaluation and Management services and Minor Procedures, resolve denials and work with leadership to put processes in place to reduce denials. Enjoy flexible remote / hybrid options, continuous career development, and competitive compensation in a supportive environment. Independently performs complex professional coding across multiple specialties and settings, including office/clinic, hospital outpatient, ED/urgent care, ASC, SNF/nursing home, and telehealth. Applies advanced coding judgment, payer policy interpretation, and documentation standards to support compliant reimbursement, wRVU integrity, and audit defensibility in an academic and research enterprise.
Requirements
- High School diploma or GED required.
- At least 3 years of experience physician/provider coding required.
- CPC or CCS-P required
Responsibilities
- Code complex professional encounters and procedures; ensure correct sequencing, modifiers, E/M level selection, and documentation alignment. Advanced expertise in ICD‑10‑CM, CPT®, HCPCS, and modifiers; strong E/M coding proficiency and payer policy interpretation.
- Resolve coding-related edits and denials by identifying root cause, coordinating documentation clarification, and supporting rebilling actions as applicable.
- Apply payer medical policies, NCCI concepts, global service considerations, and telehealth coding rules as relevant to pro fee claims.
- Provide real‑time guidance to peers on standard coding scenarios; promote consistency through best‑practice sharing.
- Participate in internal quality review programs and implement education/corrective actions based on findings.
- Proficiency in Epic professional coding work queues and encoder tools; ability to efficiently review documentation in the EHR across settings.
- Analytical problem solving for denial/edits prevention; ability to identify documentation improvement opportunities and support compliant query workflows
- Working knowledge of risk adjustment concepts and HCC validation where applicable to supported populations.
- Performs other duties as assigned
Benefits
- PTO
- 401(k)
- medical and dental plans
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
