Assigns and reviews the accuracy of diagnostic codes (ICD-10-CM) and CPT codes for providers' evaluation and management services, procedures, and diagnostic testing across all settings for billing, research, and reporting to government and regulatory agencies.
Responsible for translating patient diagnoses, treatments, and procedures into standardized medical codes to support accurate billing, regulatory compliance, and the integrity of patient health records.
Reviews medical record documentation to assign ICD-10-CM, CPT-4, HCPCS, and modifiers in a timely manner. Manages charge review and coding-related claim edit work queues, resolves charge sessions that fail edits, and identifies opportunities to improve coding accuracy and charge capture.
Assists physicians and providers with coding and documentation questions, provides feedback on documentation patterns, and communicates trends to coding leadership and provider education teams. Ensures coded services comply with governmental regulations, NCCI, and payer-specific guidelines.
Uses available resources such as Epic, diagnostic imaging systems, lab systems, emergency systems, and coding reference tools to support accurate code assignment. Trains and mentors Coding Quality Specialist Level 1 staff, performs peer review as directed, and queries physicians when clarification is needed to complete accurate coding.
High school diploma or GED required.
At least 2 years of relevant coding experience required.
Certified Professional Coder (CPC) required.
Comprehensive medical, dental, and vision insurance
Paid time off
Long-term and short-term disability coverage
Retirement savings
Health savings plans and flexible spending accounts
Certification and education support
Generous paid time off
Location
Virginia, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago