Charge Entry / Certified Professional Coder (CPC)

Responsible for accurate review, abstraction, coding, and charge validation of professional and facility services for a multi-site pain management practice and ambulatory surgery center (ASC).

This role ensures services are coded in compliance with federal and state regulations, payer guidelines, National Correct Coding Initiative (NCCI) edits, and organizational policies.

The coder reviews provider documentation to assign CPT, HCPCS, and ICD-10-CM codes for office visits, interventional pain procedures, ASC procedures, fluoroscopy, ultrasound guidance, and related ancillary services. The position also serves as a resource for physicians, advanced practice providers, clinical staff, and revenue cycle teams regarding documentation and coding requirements.

Core responsibilities

• Review physician, APP, and ASC operative documentation for completeness and coding accuracy.
• Assign ICD-10-CM, CPT, and HCPCS codes for pain management services and procedures.
• Ensure coding is supported by medical documentation and official coding guidelines.
• Apply payer-specific billing requirements and modifier usage.
• Review and validate Evaluation & Management services using CMS and AMA guidelines.
• Audit and code operative reports for ASC facility billing.
• Verify medical necessity requirements and diagnosis-to-procedure linkage.
• Correct coding errors and identify documentation deficiencies prior to claim submission.
• Review and resolve coding edits, claim rejections, and coding-related denials.

Additional duties

• Code pain management procedures such as epidural steroid injections, facet joint injections, medial branch blocks, radiofrequency ablation, sacroiliac joint injections, peripheral nerve blocks, spinal cord stimulator procedures, pain pump procedures, kyphoplasty, vertebroplasty, and imaging guidance.
• Review operative reports and facility documentation for ASC coding and revenue code assignment.
• Support compliance and quality assurance activities, including audits and payer review requests.
• Educate physicians and APPs on coding, documentation, and reimbursement requirements.
• Collaborate with charge entry, billing, accounts receivable, credentialing, and revenue cycle teams.
• Assist with coding-related appeals, denial management, and EHR/practice management system optimization.