Profee Coder (Remote)

Insight Global; Brentwood (TN); Remote; USD 65,000 - 90,000; Full time

Job summary

Insight Global seeks an experienced Professional Fee Coder to code hospital-based professional services in a fully remote setup. You will apply ICD-10-CM, CPT, and HCPCS guidelines, assign E/M levels, and ensure accurate documentation to support reimbursements.

Ideal candidates have 3+ years of Pro-Fee coding, active AAPC/AHIMA credentials, and Cerner EMR experience. Strong communication and multitasking abilities are essential for success in a remote, multi-department environment.

Qualifications

• 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.
• 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.

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.

Skills

Professional Fee Coding

AAPC/AHIMA Certification

RHIT/RHIA/CPC Certification

Clinic/Professional Coding

E/M Coding Expertise

ICD-10-CM CPT HCPCS

Remote Work Experience

Outlook/Excel/Teams

ED Coding Experience

Multi-Specialty Coding

Regulatory Reporting

Hospital Health System Background

Mentoring/Training

Additional Certifications

Tools

Cerner EMR

Job description

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.

Skills and Requirements

• 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.
• 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.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

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