Remote Physician Pro Fee Coding Specialist-Denials

CHS Corporate; United States; A distancia; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

CHS Corporate is seeking a Remote Physician Pro Fee Coding Specialist (Denials for OBGYN) to review medical records and assign CPT, HCPCS, and ICD-10 codes for professional services. You will ensure proper sequencing, modifiers, and place-of-service coding in line with regulations and payer policies.

You will perform coding audits, support provider education, resolve claim edits, and collaborate with physicians and revenue cycle teams to improve documentation, coding accuracy, and reimbursement.

Formación

• H.S. Diploma or GED required
• Associate Degree in Health Information Management, Healthcare Administration, or 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

Responsabilidades

• Assign accurate CPT, HCPCS, and ICD-10 codes for professional services based on provider documentation.
• Ensure compliance with governmental regulations, payer policies, and corporate coding protocols (NCCI, LCDs, NCDs).
• Perform coding audits and quality reviews to verify documentation accuracy and identify provider education needs.
• Work coding-related claim edits and scrubs in the billing system to ensure timely reimbursement.
• Collaborate with physicians and revenue cycle teams to ensure documentation and compliance.
• Perform edit checks on coded data before transmittal and correct errors.
• Maintain patient confidentiality per HIPAA and corporate policies.
• Escalate documentation or coding issues to the education team for training.
• Assist in coding-related special projects for reporting and analysis.
• Perform other duties as assigned and maintain regular attendance.
• Comply with all policies and standards.

Conocimientos

ICD-10 coding

CPT coding

HCPCS coding

Documentation analysis

Communication skills

Educación

H.S. Diploma or GED

AS degree in HIM/related field

Herramientas

Athena Collector

EHR systems

Descripción del empleo

United States

Trending

Job Description

Job Summary
The Remote Physician Pro Fee Coding Specialist- Denials (OBGYN) 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 escalation 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

Job Info

• Job Identification 167659
• Job Category Health Information Mgmt
• Posting Date 10/09/2026, 08:54 PM
• Job Schedule Full time
• Job Shift Day
• Locations 4000 Meridian Blvd, Franklin, TN, 37067, US