At Alteva RCM, the Professional Coder is responsible for accurately reviewing clinical documentation and assigning diagnosis codes, CPT codes, and other required codes for professional services across assigned specialties. This role applies official coding guidelines, regulatory requirements, and payer-specific rules to ensure accurate code selection, clean claim submission, and timely reimbursement.
By ensuring coding accuracy and compliance, the coder helps optimize revenue cycle performance, reduce claim denials and audit risk, support regulatory compliance, and contribute to the organization's financial health and operational success.
Key responsibilities
- Review clinical documentation and assign diagnosis and procedure codes for professional services in accordance with official coding guidance and payer requirements.
- Code assigned tickets accurately and in a timely manner to support clean claim submission and maximize appropriate reimbursement.
- Independently research and resolve coding scenarios, including payer-specific edits and documentation questions, using available resources and tools.
- Meet daily productivity targets and maintain consistent coding quality.
- Communicate coding and documentation issues, trends, and potential risks to the Lead Medical Coder and/or Medical Coding Manager.
- Escalate complex scenarios or unclear documentation through established workflows to support timely resolution.
- Maintain current knowledge of coding guidelines and payer policies and keep required credentials in good standing.
- Participate in department meetings and ongoing education, and expand coding skills into additional specialties as business needs evolve.
- Perform other duties as assigned by leadership.
Performance metrics
- Complete coding for all assigned cases within a 48-hour period.
- Meet daily productivity output targets.
- Maintain an individual coding accuracy rate of 95% or higher.
- Ensure timely escalation and high-quality documentation.
- Maintain credential and continuing education compliance.
Qualifications
- Successful completion of an AHIMA- or AAPC-approved coding program with an active credential in good standing, such as CPC or CCS; CPC preferred.
- Minimum of 3 years of recent hands-on physician/professional services coding experience across one or more specialties.
- Proficiency in anatomy and physiology, medical terminology, CPT, ICD-10-CM, modifiers, disease processes, and applicable Medicare/Medicaid policies for professional services.
- High school diploma or equivalent required; associate's or bachelor's degree preferred.
- Proficiency in Microsoft Office applications, including Excel, Word, and Outlook; experience with reporting and data analysis tools preferred.
- Ability to multi-task, prioritize workload, and meet deadlines in a fast-paced environment.
- Strong communication and interpersonal skills.
- Experience coding professional services across multiple specialties and service lines, such as surgical, anesthesia, and E/M, preferred.
- Experience using encoder tools and queue-based workflow systems to manage volume and turnaround time preferred.
- Prior participation in coding audits, denial prevention initiatives, or documentation improvement efforts preferred.
- Strong knowledge of HIPAA regulations and healthcare privacy laws.
- Exceptional attention to detail and organizational skills.
- Ability to work independently while contributing to a team-oriented environment.
- Demonstrated problem-solving skills with a proactive, solution-driven approach.
Alteva RCM offers a comprehensive benefits package, including:
- Health insurance
- Dental insurance
- Vision insurance
- Employee assistance plan
- Paid family leave
- Short-term disability
- Life insurance
- 401(k) with employer match
- Flexible spending accounts
- Employee discount program
- Employee referral program
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Salary Range
$60,000 - $90,000
Remote work allowed
Yes
Posted
1 week ago