Remote Physician Pro Fee Coding Specialist - Denials

The Remote Physician Pro Fee Coding Specialist - Denials (OBGYN) is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards.

The physician coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement.

Essential functions

• Assign accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation.
• Ensure compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following NCCI edits, LCDs, and NCDs.
• Perform coding audits and quality reviews, verify documentation accuracy, and identify areas for provider education.
• Work coding-related claim edits, holds, and scrubs in the electronic billing system, ensuring timely claim resolution and reimbursement.
• Collaborate with physicians, revenue cycle teams, and coding education staff, requesting clarification when needed to ensure optimal documentation and compliance.
• Perform edit checks on coded data before transmittal, identifying and correcting errors as needed.
• Maintain strict confidentiality of patient records, provider information, and financial data in accordance with HIPAA and corporate compliance policies.
• Escalate documentation or coding issues to the coding education team for provider training and improved documentation practices.
• Assist with coding-related special projects and support accurate reporting and analysis of coding data for operational improvement.
• Perform other duties as assigned and maintain regular attendance.