Professional Fee Coder - Radiology (Full Time, Day) Onsite, Hybrid, Remote

Northbay; United States; Hybrid; USD 60,000 - 90,000; Full time

Job summary

NorthBay Health is seeking a Professional Fee Radiology Coder to deliver accurate radiology coding for professional services across diverse imaging modalities. The role emphasizes independent work, meticulous review of provider documentation, and strict adherence to CPT/HCPCS, ICD-10-CM, NCCI, and payer policies.

Flexibility is offered with onsite preference and remote eligibility within the continental United States, subject to state-specific requirements.

Qualifications

• Strong knowledge of radiology terminology and anatomy.
• Ability to work independently with high accuracy.
• Proficient in CPT/HCPCS and ICD-10-CM coding.
• Understanding of payer requirements and CMS guidelines.

Responsibilities

• Review radiology reports and assign CPT/HCPCS and ICD-10-CM codes for professional services.
• Apply appropriate modifiers and professional component coding requirements.
• Ensure documentation supports medical necessity and service billed.
• Resolve coding edits and work queue items to support timely submission.
• Escalate documentation deficiencies through established processes.
• Maintain compliance with CMS, AMA/CPT, NCCI and HIPAA.

Skills

Radiology coding

Attention to detail

Documentation quality

CMS guidelines

Analytical thinking

Tools

EHR platforms

Coding platforms

Job description

Work Location Requirement: This position may be performed onsite or remotely; however, onsite work is preferred based on business needs. Preference will be given to qualified candidates who are able to work onsite and are located within a reasonable commuting distance. Remote Work Eligibility: This position is open to candidates located within the continental United States. Due to state-specific employment requirements and workers’ compensation regulations, we are unable to support remote work arrangements in the following locations: Washington, Ohio, Wyoming, North Dakota, Puerto Rico, and the U.S. Virgin Islands.

At Northbay Health, the Professional Fee Radiology Coder is responsible for accurate and timely professional fee coding of radiology services based on provider documentation and applicable coding guidelines. This role reviews radiology documentation and assigns appropriate CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, and modifiers for professional fee billing. The coder ensures coding accuracy, documentation integrity, medical necessity support, and compliance with CMS, AMA/CPT, NCCI, payer-specific requirements, and NorthBay standards. Requires strong knowledge of radiology terminology, anatomy and physiology, diagnostic imaging services, professional component coding, and the ability to work independently with high accuracy in any EHR or coding/billing platform.

PRIMARY JOB DUTIES

Professional Fee Radiology Coding Reviews radiology reports and related clinical documentation and assigns accurate CPT/HCPCS and ICD-10-CM codes for professional fee radiology services within assigned work queues and service areas. Applies appropriate modifiers and professional component coding requirements based on documentation, service performed, payer requirements, and established departmental guidelines. Codes assigned diagnostic imaging services, which may include radiography, CT, MRI, ultrasound, mammography, nuclear medicine, PET, fluoroscopy, and other radiology services within departmental scope. Validates that documentation supports the procedure, diagnosis, medical necessity, and service billed; identifies documentation discrepancies or incomplete information requiring clarification. Applies current CPT, HCPCS, ICD-10-CM, NCCI, CMS, AMA, and payer-specific coding guidance to assigned radiology encounters.

Coding Edits & Workflow Resolution

Reviews and resolves coding-related edits and work queue items within the current EHR/coding platform to support timely and accurate claim submission. Validates CPT/HCPCS, ICD-10-CM, and modifier accuracy and makes appropriate coding corrections prior to billing. Escalates documentation deficiencies, conflicting information, or coding questions through established provider query and departmental escalation processes. Identifies recurring coding, documentation, or workflow issues and communicates trends to Professional Coding leadership.

Coding Quality & Compliance

Maintains coding accuracy and productivity in accordance with departmental standards and assigned turnaround times. Reviews available clinical documentation and coding resources to ensure complete, compliant professional fee coding of assigned radiology services. Maintains current knowledge of radiology coding changes, annual CPT/HCPCS and ICD-10-CM updates, payer guidance, and regulatory requirements.

Collaboration & Documentation Support

Communicates coding and documentation questions clearly and professionally with Professional Coding leadership, providers, and applicable Revenue Cycle partners. Participates in coding education, workflow updates, and department meetings as assigned. Supports identification of documentation opportunities that affect radiology coding accuracy, medical necessity, or claim submission. Assists with coding research and provides supporting references when escalating complex radiology coding questions.

Compliance & Quality

Ensures all work complies with CMS, AMA/CPT, NCCI, payer policies, HIPAA requirements, and NorthBay standards. Maintains strict confidentiality and protects patient and organizational information in accordance with HIPAA and NorthBay policy. Supports continuous improvement of professional fee radiology coding workflows, quality, and claim accuracy.

Professional Standards

Demonstrates and role models the NorthBay True North Values:

• Nurture Care (Compassion)
• Own It (Accountability)
• Respect Relationships (Teamwork)
• Build Trust (Integrity)
• Hardwire Excellence (Excellence)

Performs other duties as assigned.