RCM Medical Coding Specialist — ProFee & QA Expert

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

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.