Physician Coder III, Remote

About the role

This remote position supports physician and mid-level provider professional services coding across multiple specialties and chart types. The role requires high-volume accuracy with minimal supervision, professional office skills, and the ability to navigate a practice management system while serving as a liaison between management, physician practices, and practice employees.

Responsibilities

• Review and analyze electronic and/or paper medical records to accurately code episodes of care across 1–4 specialties (e.g., UR, Podiatry, Plastics, Pediatrics, OB, Pain Management, Ortho, Addiction, General Surgery, Internal Medicine, Urgent Care, Pulmonary, ED).
• Calculate ProFee and/or Facility E/M levels per AMA guidelines; recognize critical care cases by patient acuity.
• Apply ICD-10-CM diagnosis codes to the highest specificity; accurately assign CPT, HCPCS, and ICD-10-CM codes.
• Interpret coding guidelines and maintain understanding of National Correct Coding Initiatives, Local Coverage Documents, MUEs, and Medicare Teaching Physician Guidelines.
• Apply regulatory requirements and institutional guidelines to select appropriate codes and modifiers; assess documentation impact on reimbursement.
• Align conduct with AHIMA Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct; support the Ethics and Compliance Program.
• Adhere to DNV and other third-party documentation guidelines to minimize risk; continually improve coding quality and accuracy.
• Maintain current ICD-10-CM, CPT, and HCPCS coding knowledge and certification; obtain physician clarification when documentation is incomplete.
• Communicate with providers to resolve conflicting documentation; provide feedback during charge review and resolve payer denials.
• Respond to revenue cycle inquiries, process charge corrections, and comply with internal policies and procedures.
• Participate in company-provided training and education; protect confidential information including PHI.
• Meet or exceed productivity and quality standards defined by department leadership.

Requirements

• Knowledge of anatomy and physiology, disease pathology, and medical terminology.
• Proficiency in ICD-10-CM coding conventions and CMS Official Guidelines for Coding and Reporting.
• Ability to translate diagnostic descriptions into accurate ICD-10-CM, CPT, and HCPCS codes for optimal reimbursement across payer types.
• Experience navigating EMRs to identify documentation for coding and billing.
• Current CPC certification (CBCS grandfathered for existing Erlanger staff).
• Minimum 4 years of coding experience in a physician office or hospital HIM department, including E/M level and/or surgical CPT coding across multiple specialties.
• Data entry and keyboard proficiency; experience with Excel, MS Word, and Adobe.
• Effective written and oral communication; ability to handle multiple tasks and train others.

Preferred Qualifications

• BS or AS in Health Information Management/Technology from an accredited program.
• Experience in both E&M and surgical coding, physician office setting, and EPIC systems.
• Ability to audit E/M levels for correct assignment.