Charge Entry / Certified Professional Coder (CPC)

The Certified Professional Coder (CPC) is responsible for accurate review, abstraction, coding, and charge validation of professional and facility services for a large multi-site pain management practice and Ambulatory Surgery Center (ASC). This role ensures all services are coded in compliance with federal and state regulations, payer guidelines, 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 supports physicians, advanced practice providers, clinical staff, and revenue cycle teams with documentation and coding guidance.

Key responsibilities include:

• Reviewing physician, APP, and ASC operative documentation for completeness and coding accuracy
• Assigning ICD-10-CM, CPT, and HCPCS codes for pain management services and procedures
• Ensuring coding is supported by medical documentation and official coding guidelines
• Applying payer-specific billing requirements and modifier usage
• Validating E&M services using current CMS and AMA guidelines
• Auditing and coding operative reports for ASC facility billing
• Verifying medical necessity and diagnosis-to-procedure linkage
• Correcting coding errors and identifying documentation deficiencies before claim submission
• Reviewing coding edits, claim rejections, and coding-related denials
• Coding pain management procedures including epidural steroid injections, facet joint injections, medial branch blocks, radiofrequency ablation, sacroiliac joint injections, peripheral nerve blocks, trigger point injections, spinal cord stimulator trials and implants, intrathecal pain pump procedures, kyphoplasty, vertebroplasty, and guidance services
• Supporting ASC facility coding, revenue codes, reimbursement, compliance, provider education, and revenue cycle collaboration