Remote Physician Pro Fee Coding Specialist-Cardiology

Community Health Systems, Inc.; Franklin (TN); Teletrabalho; USD 70 000 - 110 000; Tempo integral

Resumo da oferta

Community Health Systems, Inc. seeks a Remote Physician Pro Fee Coder specializing in Cardiology to review, analyze, and assign CPT, HCPCS, and ICD-10 codes for professional services from provider documentation.

You will ensure proper sequencing and modifiers, comply with NCCI edits and LCD/NCD guidelines, perform coding audits, and collaborate with physicians and revenue cycle teams to support accurate reimbursement.

Qualificações

• H.S. Diploma or GED required.
• Associate Degree in Health Information Management, Healthcare Administration, or related field preferred.
• 2-4 years of physician coding experience required.
• Experience with multiple specialties or high-volume professional fee coding preferred.

Responsabilidades

• Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services based on documentation.
• Ensures compliance with governmental regulations, payer policies, and coding protocols.
• Performs coding audits and quality reviews to improve accuracy.
• Works edits and scrubs in billing systems to ensure timely reimbursement.
• Collaborates with physicians, revenue cycle teams, and education staff.
• Maintains HIPAA confidentiality and adherence to corporate policies.
• Supports coding education and special projects as needed.

Conhecimentos

ICD-10/CPT/HCPCS coding

NCCI/LCD/NCD knowledge

Documentation gap identification

Analytical problem solving

Communication and collaboration

Formação académica

High School Diploma or GED

Associate degree in Health Information Management / Healthcare Administration

Ferramentas

Athena Collector

EHR systems

Descrição da oferta de emprego

Job Summary

The Remote Physician Pro Fee Coder-Cardiology is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement.

Essential Functions

• Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation.
• Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
• Performs coding audits and quality reviews, verifying accuracy of documentation and identifying areas for provider education.
• Works coding-related claim edits, holds, and scrubs in the electronic billing system (e.g., Athena Collector), ensuring timely claim resolution and reimbursement.
• Collaborates with physicians, revenue cycle teams, and coding education staff, requesting clarification when necessary to ensure optimal documentation and compliance.
• Performs edit checks on coded data before transmittal, identifying and correcting errors as needed.
• Maintains strict confidentiality of patient records, provider information, and financial data, adhering to HIPAA and corporate compliance policies.
• Escalates documentation or coding issues to the coding education team for provider training and improved documentation practices.
• Assists in coding-related special projects, ensuring accurate reporting and analysis of coding data for operational improvement.
• Performs other duties as assigned.
• Maintains regular and reliable attendance.
• Complies with all policies and standards.

Qualifications

• H.S. Diploma or GED required
• Associate Degree in Health Information Management, Healthcare Administration, or a related field preferred
• 2-4 years of experience in physician coding, professional fee coding, or medical billing required
• Experience with multiple specialties, surgical coding, or high-volume professional fee coding preferred

Knowledge, Skills and Abilities

• Strong knowledge of ICD-10, CPT, and HCPCS coding systems for physician/professional fee services.
• Understanding of modifier usage, place-of-service coding, and payer billing guidelines.
• Experience with electronic health records (EHR), coding software, and claim processing systems.
• Ability to identify documentation deficiencies and elevate for provider education.
• Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements.
• Strong analytical and problem-solving skills, ensuring accurate coding and optimal reimbursement.
• Effective communication and collaboration skills, working with providers, revenue cycle teams, and compliance staff.

Licenses and Certifications

• CCS-Certified Coding Specialist (CCS-P) required or
• Certified Coder-AHIMA or AAPC or equivalent coding certification required or
• RHIT - Registered Health Information Technician required or
• RHIA - Registered Health Information Administrator required