HIM Certified Coder, Professional Fee

The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient, and/or professional fee encounters using ICD-10, ICD-PCS, CPT, and HCPCS codes, as well as coding software such as computer-assisted coding tools and encoders. This role supports compliant billing for Carle claims, applies regulatory coding guidelines, resolves coding-related billing edits, and reviews clinical encounters in electronic medical record systems.

Responsibilities include:

• Accurately code records according to ICD-10, CPT, HCPCS, and modifier guidelines
• Ensure assigned codes correctly reflect diagnoses and procedures
• Provide interdepartmental coding assistance to support accurate code assignment
• Apply regulatory and compliance standards using CMS publications, Coding Clinic, CPT Assistant, and other reference materials
• Support revenue optimization while maintaining compliance
• Assist with auditing, monitoring, training, claim scrubber workflows, and coding/billing inquiries
• Serve as a resource for CPT, HCPCS, ICD-10-CM, and other coding systems
• Act as a liaison between coding and billing staff to support accurate charge capture
• Report documentation and coding improvement needs
• Perform provider and peer coding audits as requested
• Help monitor internal controls and support external audit activities