Senior Professional Coder

The Senior Professional Coder applies advanced professional coding expertise to support professional fee coding, charging, and denials follow-up. This role serves as a team lead and subject matter expert, collaborating with staff and providers to ensure timely, accurate, and compliant coding processes.

This position is remote, but onsite education to providers is required as needed.

Responsibilities include:

• Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges for compliance with federal and state regulations and payer guidelines.
• Support daily coding team operations in a team lead capacity and help ensure productivity and quality standards are met.
• Perform accurate professional fee coding and assist with supervisory coverage when needed.
• Define and submit coding and edit rules to improve accuracy and efficiency across systems.
• Participate in application testing, charge import workflows, troubleshooting, and vendor software support.
• Assist with staff scheduling, training, feedback, evaluation, and departmental goal setting.
• Help recruit and interview candidates for open positions.
• Perform system manager duties in the absence of the assigned system manager.
• Conduct chart reviews and HCC/risk adjustment coding validation to ensure compliance with CMS and ICD-10-CM guidelines.
• Conduct professional fee billing integrity audits and identify documentation improvement opportunities.
• Analyze audit trends, recommend corrective actions, and provide education to reduce denials.
• Serve as liaison for external audits and implement changes based on findings.
• Participate in meetings, coverage planning, and professional development activities.