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

NorthBay Health; United States; Hybrid; USD 90,000 - 120,000; Full time

Job summary

NorthBay Health is seeking a Professional Fee Radiology Coder to code radiology services for professional billing. The role may be performed onsite or remotely, with onsite work preferred based on business needs and commuting distance.

The candidate will review documentation, assign CPT/HCPCS and ICD-10-CM codes, apply modifiers, and ensure medical necessity and CMS/payer compliance across radiology services. Strong EHR and coding workflow experience is required.

Qualifications

• Minimum 3 years of professional radiology coding experience.
• Strong knowledge of CPT/HCPCS, ICD-10-CM, modifiers, and professional component requirements.
• Knowledge of radiology terminology, anatomy, physiology, and coding guidelines.
• Proficiency with EHRs, encoders, coding/billing workflows, and Microsoft Office.

Responsibilities

• Review radiology reports and clinical documentation to assign CPT/HCPCS and ICD-10-CM codes for professional radiology services.
• Apply modifiers and professional component coding requirements based on documentation and payer rules.
• Ensure documentation supports procedure, diagnosis, medical necessity, and billing; resolve discrepancies.
• Review and resolve coding-related edits and queue items to support timely submission.

Skills

Radiology terminology

Anatomy & physiology

Professional coding

CPT/HCPCS

ICD-10-CM knowledge

EHR software

Education

Associate or Bachelor's degree

Coding certification preferred

Tools

3M encoder

Microsoft Office

Job description

Professional Fee Radiology Coder

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.

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.

Qualifications

Education

• Associate's or Bachelor's degree preferred.

Certification

• Radiology-specific coding education or specialty certification preferred; additional specialty credentials may be required based on assigned radiology scope.
• Requires one of the following credentials:
  • CPC
  • CCS-P
  • CCS
  • COC

Experience

• Minimum 3 years of professional radiology coding experience.
• Demonstrated knowledge of professional fee radiology coding, including CPT/HCPCS, ICD-10-CM, modifiers, and professional component requirements.
• Strong knowledge of anatomy, physiology, medical terminology, radiology terminology, disease processes, and official coding guidelines.
• Proficiency with EHRs, encoders (e.g., 3M), coding/billing work queues, and Microsoft Office.

Standards of Performance

• Demonstrate performance by adhering to established policies and procedures and exhibiting the defined characteristics associated with attendance and punctuality.

About Us

Interpersonal Skills and Values

Demonstrates NorthBay Health's True North Values: Nurture Care, Own It, Respect Relationships, Build Trust, and Hardwire Excellence. These values guide behavior, accountability, teamwork, and commitment to high-quality patient care.

Why NorthBay Health

NorthBay Health is an independent, nonprofit health system serving the Napa, Solano, and Yolo County regions. We are expanding access to care across our communities through two acute-care hospitals, including a Level II Trauma Center and a Level III NICU maternity unit, along with a cancer center, urgent care locations, and a growing network of primary and specialty care clinics.

We provide advanced services in cardiovascular care, neuroscience, orthopedics, surgery, and outpatient specialties. NorthBay Health is nationally recognized for quality care, including Magnet with Distinction designation for nursing and multiple U.S. News and World Report high performing recognitions.

We are committed to being the trusted healthcare partner of choice and offer an® environment where employees can grow, contribute meaningfully, and support the health of our communities.

NorthBay Health Benefits Options

NorthBay Health offers a comprehensive benefits package based on established eligibility requirements. Benefits may include medical, dental, and vision insurance, life, disability and long-term care coverage, paid time off including vacation, sick leave, holidays, and bereavement, a 403(b) retirement plan with employer match, education reimbursement for eligible roles, professional development and training programs, Employee Assistance Program, wellness programs, recognition programs, shift differentials, and market-based compensation review and increases subject to approval and organizational performance.

Compensation Structure

NorthBay Health uses a structured compensation framework. Staff-level positions use a step-based system (Steps 1-5) based on years of directly related experience, with Step 5 representing 20 or more years of experience in the role. Manager level and above positions are paid a fixed annual base salary and are eligible for a variable incentive compensation plan. Physician compensation is structured based on specialty and role requirements.

Remote Work Disclosure

NorthBay Health is primarily an onsite organization due to the nature of healthcare. Some roles may allow hybrid or remote work based on business needs.

Remote work is not supported in Washington, Ohio, Wyoming, North Dakota, Puerto Rico, the U.S. Virgin Islands, or outside of the United States.

Notice to Recruitment Agencies

NorthBay Health utilizes a managed service provider (MSP) for agency partnerships and is not currently engaging external recruiting firms outside of established agreements. We do not accept unsolicited resumes or third-party candidate submissions. Please do not contact NorthBay Health employees, leaders, physicians