Revenue Cycle Coder (CPC) - Remote

Proliance Puget Sound Orthopaedics; Seattle (WA); Remote; USD 65,000 - 85,000; Full time

Job summary

Proliance Surgeons is seeking a remote Revenue Cycle Coder to support our orthopedic coding and billing operations. The role focuses on accurate ICD-10, CPT-4, and HCPCS coding aligned with payer guidelines, while collaborating with physicians and the revenue cycle team.

The ideal candidate has 3+ years of coding/medical billing experience, AHIMA or AAPC certification, and ICD-10 proficiency. This is a full-time remote opportunity with standard M–F hours and PST time zone alignment.

Qualifications

• Minimum 3 years coding/medical billing experience.
• AHIMA or AAPC coder certification (maintained annually).
• ICD10 certified or extensive coding experience.

Responsibilities

• Review and audit medical records to assign correct ICD10, CPT-4, and HCPCS codes per regulations.
• Utilize coding software and references effectively.
• Follow up with providers on unclear or missing documentation.
• Provide education and feedback to providers based on coding observations and trends.
• Stay updated on payer policies and guidelines to ensure compliance with Medicare, NCCI, and other payers.
• Review and resolve suspended charges due to claim edits or payor rejections.
• Analyze denial trends with leadership to drive process improvements.
• Perform other duties as assigned.

Skills

Orthopedic coding

Medical terminology

EHR navigation

Attention to detail

Communication skills

Education

3 years coding/medical billing experience

AHIMA/AAPC coder certification

ICD10 certified or extensive coding experience

Tools

Microsoft Excel

Outlook

Adobe

Job description

Revenue Cycle Coder

At Proliance Surgeons our patients come from all walks of life and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered.

The role of the remote Revenue Cycle Coder is crucial to the revenue cycle team. The team connects with our patients, their insurers or bill payers and our physicians. Accuracy and efficiency of this team directly impacts our mission to be the leader in physician-managed healthcare services and to provide excellent surgical and clinical care for every patient, every day. The Revenue Cycle Coder is critical to maintaining the funding for our services provided.

Schedule

Full-time, Monday - Friday, 8am - 5pm PST.

In order to be eligible for hire in a remote position with Proliance, applicants must reside in one of the following States: WA, FL, NC, AZ, ID, OH, OR, TN, TX, or RI.

Key Duties and Responsibilities

The key duties and responsibilities of the Revenue Cycle Coder include, but are not limited to:

• Reviews/audits and interprets medical record documentation to identify pertinent diagnosis/procedure and apply correct ICD10, CPT-4, and HCPC's codes in accordance with government and insurance regulations.
• Demonstrates appropriate utilization of coding software and coding reference material.
• Follow up with providers on any documentation that is insufficient, missing, or unclear.
• Assists providers with questions regarding coding and documentation guidelines. Provides ongoing feedback based on observations from coding documentation and identifies opportunities for education and communicates trends to leaders.
• Keeps up to date on carrier policies/guidelines to ensure all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or Payer-specific guidelines.
• Reviews and resolves suspended charges due to claim edits or payor rejections related to coding.
• Reviews, corrects and appeals coding-related denials trends and shares with leadership, and team members to facilitate root cause analysis and continuous process improvement.
• Corrects and/or appeals denied claims due to coding errors
• Other duties as assigned

Education/Experience

• Minimum 3 years coding/medical billing experience
• Professional coder certification with credentialing from AHIMA and/or AAPC, must be maintained annually
• ICD10 certified and/or extensive work experience

Knowledge, Skills and Abilities

• Orthopedic coding experience is strongly preferred, particularly experience supporting high-volume orthopedic and surgical clinics.
• A strong understanding of physiology, medical terms, and anatomy
• Thorough attention to detail
• Excellent written and verbal communication skills
• Self-motivated team player able to multi-task and prioritize
• Excellent organization and interpersonal communication skills
• Strong computer skills
• Strong computer skills/experience with Microsoft Excel, Outlook, and Adobe
• Working experience navigating EHR's to abstract documentation

Work Environment/Physical Demands

The remote work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Work may be performed in an office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.