RCM Medical Coding Processor

Francisco Partners; United States; On-site; USD 65,000 - 85,000; Full time

Job summary

Veradigm is seeking a Medical Coding Reviewer to ensure coding accuracy and compliance with AMA CPT, ICD-10-CM, CMS, NCCI and payer guidelines. The role collaborates with providers and internal teams to improve coding quality and reduce risk.

The position requires CPC or CPC-A credentials and 2+ years of ProFee abstract medical coding experience, with strong attention to detail and excellent communication skills. EHRs and auditing tools proficiency is expected.

Qualifications

• AAPC credential required: CPC or CPC-A
• 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

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

Attention to detail

Analytical thinking

Communication skills

Tools

EHR proficiency

Coding/auditing tools

Job description

This role is responsible for reviewing medical records to ensure coding accuracy, compliance, and alignment with AMA CPT, ICD-10-CM, CMS, NCCI and payer guidelines. The position interacts and collaborates with providers, vendors and internal teams to support coding integrity, compliance risk mitigation, and drives continuous quality improvement through targeted education, documentation, coding related feedback, and coding denial support.

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 or CPC-A
• 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.

Enhancing Lives and Building Careers

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network.

Visa Sponsorship is not offered for this position.

Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

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.

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