RCM Medical Coding Processor

Veradigm®; Raleigh (NC); On-site; USD 65,000 - 90,000; Full time

Job summary

Veradigm is seeking a skilled ProFee medical coder to abstract E/M visits and office-based services with accuracy and regulatory compliance. You will perform daily QA on coded services, provide targeted education, and validate CPT/ICD-10-CM/HCPCS assignments against clinical documentation to uphold AMA CPT, ICD-10, CMS, and payer guidelines.

The role requires CPC certification, 2+ years of ProFee coding experience, and strong attention to detail.

Qualifications

• AAPC credential CPC required.
• 2+ years of ProFee abstract medical coding.
• Proficient knowledge of E/M documentation guidelines.
• Proficient knowledge of Modifier rules and NCCI edits.
• Proficient knowledge of CPT, ICD-10-CM, HCPCS Level II.

Responsibilities

• Abstract coding of all pro-fee E/M visits and office-based services and procedures.
• Daily QA evaluation of coded services to ensure accuracy of completed coding.
• Provide targeted coding education and feedback.
• Validate ICD-10-CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelines.
• Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps.
• Support coding education through feedback, targeted training, and reference materials.
• Provide actionable recommendations to address coding findings and reduce coding errors.
• Support denial prevention, resolution and appeal strategies.
• Collaborate across teams to assist with coding support.

Skills

CPC

ProFee coding

E/M guidelines

NCCI edits

CPT/ICD-10/HCPCS

EHRs

Job description

Key Responsibilities

• Abstract coding of all (pro‑fee) E/M visits and office‑based services and procedures
• Daily QA evaluation of coded services to ensure accuracy of completed coding
• Provide targeted coding education and feedback
• Validate ICD‑10‑CM, CPT®, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD‑10, CMS, NCCI, and payer‑specific guidelines
• Identify coding discrepancies, compliance risks, trends, root causes, and documentation gaps
• Support coding education through feedback, targeted training, and reference materials
• Provide actionable recommendations to address coding findings and reduce coding errors
• Support denial prevention, resolution and appeal strategies
• Collaborate across teams to assist with coding support

Required Qualifications

• AAPC credential required: CPC
• 2+ years of ProFee abstract medical coding
• Proficient knowledge of:
• E/M documentation guidelines
• Modifier rules and NCCI edits
• CPT, ICD‑10‑CM, HCPCS Level II
• High attention to detail with strong analytical and critical‑thinking skills
• Excellent written and verbal communication skills for coding feedback and education
• Proficiency with EHRs, coding and auditing tools

Compensation for this job is subject to market conditions, geographic considerations, the candidate’s unique skills and experience, state and local laws, and budget. Our commitment to pay transparency is a testament to our dedication to creating a fair, equitable, and inclusive workplace. By continuously analyzing market trends, staying abreast of changes in state laws, and making budgetary adjustments accordingly, we strive to ensure that our compensation practices reflect the value we place on our associates’ unique contributions and support their professional growth.

Visa Sponsorship is not offered for this position.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans.

Veradigm’s policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.