Remote Physician Pro Fee Coding Specialist-Denials

Community Health Systems; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Community Health Systems seeks a Remote Physician Pro Fee Coding Specialist (OBGYN) to assign CPT/HCPCS/ICD-10 codes for professional services, ensuring compliant sequencing and proper modifiers. You will work with physicians and billing teams to support accurate reimbursements while upholding HIPAA and corporate standards.

The role requires 2–4 years of physician coding or medical billing experience, familiarity with EHRs, and proficiency in coding software.

Qualifications

• H.S. Diploma or GED required.
• Associate degree in HIM or related field preferred.
• 2–4 years of physician coding or medical billing experience.

Responsibilities

• Assigns CPT, HCPCS, and ICD-10 codes for professional services based on docs.
• Ensures compliance with regulations, LCDs/NCDs, and NCCI edits.
• Performs coding audits and quality reviews; educates providers as needed.
• Handles claim edits and scrubs in the billing system for timely reimbursements.
• Collaborates with physicians and revenue cycle teams to improve documentation.
• Performs edit checks before transmittal and corrects errors.
• Maintains HIPAA confidentiality and corporate compliance.
• Escalates coding issues to education team for training.
• Supports coding-related special projects and data reporting.

Skills

CPT coding

HCPCS coding

ICD-10 coding

NCCI edits

EHR experience

Claim processing systems

Athena Collector

Communication skills

Education

HS Diploma or GED

Associate Degree in Health Information Management or related field

Tools

Athena Collector

Job description

United States

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 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

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