Medical Coder

This hybrid-to-remote role is responsible for reviewing operative reports and documentation for surgery and other facility-based charges, assigning appropriate CPT and ICD-10 codes, and entering charges into the practice management system. The role also reviews and audits charge tickets for office services to ensure correctness and completeness before billing and claim submission.

The coder serves as a resource for charge posters with coding questions and supports the A/R team with correct claim processing and appeals.

Department Responsibilities

• Read and interpret medical record documentation to identify diagnoses and significant procedures for facility-based charges.
• Review, audit, and correct charge tickets to ensure accurate CPT, ICD-10, and modifier usage.
• Contact physicians for clarification when needed to ensure accurate charge entry.
• Review and code surgical pre-certifications sent through Athena for upcoming surgeries.
• Verify that all coded services have been correctly pre-certified and route cases back for updated retro authorization when needed.
• Apply federal guidelines and coding conventions for CPT/HCPCS and ICD-10.
• Assist the billing department with claims resolution by verifying and correcting coding issues.
• Review denials and coverage policies.
• Provide coding support to all departments within the practice.
• Review operative reports and audit surgeries over $10,000.
• Support A/R staff with surgical coding questions and appeals as assigned.
• Participate in research projects involving coding and reimbursement issues.
• Audit E&M chart notes as assigned.
• Perform other related duties as assigned.