Professional Coder

Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to ensure compliance with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes in a remote role within Health Information Management.

Key responsibilities include:

• Review, analyze, and validate CPT, ICD-10 diagnosis codes, HCPCS, modifiers, and charges applied by providers.
• Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.
• Understand and apply National Correct Coding Initiative (NCCI) edits and relative value units as appropriate.
• Meet established productivity and quality standards.
• Review denials and respond appropriately and timely.
• Perform audits as assigned by management.
• Assist with application testing for identified coding workflows.
• Participate in staff meetings, department meetings, and other assigned meetings.
• Maintain professional development through webinars, workshops, and conferences when appropriate.
• Collaborate effectively with people from different disciplines and technical backgrounds.
• Stay current on insurance products, policies, procedures, and state and federal mandates related to coding and documentation.
• Interact with providers and staff to support accuracy and specificity in documentation and coding.
• Perform other duties as assigned.