Coding Reimbursement Specialist II

Alliant Human Capital; United States; Hybrid; USD 34,000 - 43,000; Full time

Job summary

Tryon Medical Partners is seeking a Coding Reimbursement Specialist II to accurately code physician services using CPT/ICD-10 and modifiers. The role supports the RCM team in a full-time hybrid or remote setting, with standard hours and a focus on compliant billing practices.

The ideal candidate has 3+ years of physician coding experience, CPC certification, and strong knowledge of payer rules, AMA guidelines, and clinical documentation interpretation.

Qualifications

• Three years’ experience with CPT and ICD-10 coding of physician services.
• Coding certification required with CPC preferred; CEUs maintained.
• Strong knowledge of medical terminology, anatomy, physiology and payer rules.

Responsibilities

• Review charges to select appropriate ICD-10 and CPT codes for physician services.
• Interpret clinical documents to assign codes per AMA guidelines.
• Enter codes, diagnoses and modifiers into the Billing system to complete charges.
• Coordinate with team to ensure timely processing of charges.
• Query physicians as needed to ensure accurate coding and billing.
• Review documentation to ensure compliance with third-party and regulatory guidelines.

Skills

CPT Coding

ICD-10 Coding

Medical Terminology

Regulatory Guidelines

Payer Rules

Education

High School Diploma

CPC Certification

Tools

TMP Billing System

Job description

Remote
Full Time
Revenue Cycle Management
Mid Level

Coding Reimbursement Specialist II

Our Client Tryon Medical Partners is hiring a Coding Reimbursement Specialist II

Job Summary:

The Coding Reimbursement Specialist II performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system.

(This is a full-time hybrid or remote position that will support the RCM team, Monday to Friday 8 am to 5 pm)

Primary Job Responsibilities/Tasks may include, but not limited to:

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

Requirements:

Education and Certifications:

• High school diploma or GED completion is required.
• A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required.
• Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure.
• Advanced working knowledge of medical terminology, anatomy, and physiology required.
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.

Experience:

• Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions.
• Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team concept.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds.
• Ability to concentrate on details.
• Use of computer for long periods of time

Hourly Rate - Based upon Experience:

• Minimum: $24.64/hour
• Midpoint: $27.68/hour
• Maximum: $31.17/hour