Remote Profee Coder

Job Description

Day-to-Day Responsibilities

• Review and code professional fee encounters using ICD-10-CM, CPT, and HCPCS guidelines.
• Assign accurate E/M levels, diagnoses, and procedure codes to ensure compliant reimbursement.
• Abstract key patient and encounter data for billing, regulatory, and reporting purposes.
• Audit medical records to ensure documentation supports services billed and identify documentation gaps.
• Communicate with physicians and providers to obtain coding and documentation clarifications.
• Review and resolve coding-related claim edits, including medical necessity and NCCI/CCI edits.
• Collaborate with billing and Accounts Receivable teams to resolve coding and reimbursement issues.
• Maintain quality and productivity standards while meeting a 95% coding accuracy requirement.
• Work within EMR, hospital information systems, and encoder software in a fully remote environment. Stay current on coding regulations, payer requirements, and continuing education requirements.

Required Skills & Experience

• 3+ years of Professional Fee (Pro-Fee) Coding experience.
• Active coding certification through AAPC or AHIMA.
• Active RHIT, RHIA, CPC, COC, CCS-P, CCS, CEDC, or equivalent coding credential.
• Experience coding clinic visits/professional services.
• Strong experience with Evaluation & Management (E/M) coding, diagnosis coding, injections, and procedure coding.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and coding compliance guidelines.
• Experience with Cerner EMR.
• Experience working remotely.
• Proficiency in Microsoft Outlook, Excel, and Teams. Strong communication, organization, and multitasking skills.

Nice To Have Skills & Experience

• Emergency Department (ED) coding experience.
• Multi-specialty Pro-Fee coding background.
• Experience with regulatory reporting and data abstraction.
• Prior hospital or health system coding experience.
• Experience partnering with AR/billing teams on claim resolution.
• History of exceeding coding productivity and quality metrics.
• Experience mentoring, training, or educating other coders. Additional AAPC or AHIMA certifications beyond minimum requirements.