Senior Professional Fee Coder

About the role

The Senior Professional Fee Coder ensures accurate and timely coding of physician and professional services by assigning appropriate ICD-10-CM and CPT codes based on clinical documentation. This role reviews medical records, resolves coding edits and charge discrepancies, and helps ensure compliant claim submission to maximize reimbursement. The coder collaborates with physicians, clinical staff, and billing teams to provide coding guidance, support revenue cycle operations, and maintain compliance with coding regulations and organizational policies. Through detailed documentation review and reconciliation of charges, this position plays a key role in the financial integrity of the organization and serves as a subject matter expert for accurate coding, charge capture, and revenue cycle support across multiple clinical specialties.

Responsibilities

• Assigns ICD-10-CM, CPT, and HCPCS codes to professional services.
• Reviews physician documentation, operative reports, procedure notes, clinic encounters, and ancillary reports to accurately assign diagnosis and procedure codes in accordance with current ICD-10-CM, CPT, HCPCS Level II, and payer-specific guidelines.
• Ensures coding accurately reflects the services performed and supports medical necessity while maintaining compliance with federal regulations, National Correct Coding Initiative (NCCI) edits, and Medicare guidelines.
• Codes a variety of surgical and evaluation and management (E/M) services across multiple specialties.
• Reviews and abstracts medical record documentation.
• Analyzes complex medical records to ensure complete and accurate charge capture.
• Interprets operative reports and physician documentation to determine the appropriate coding and sequencing of diagnoses and procedures.
• Identifies documentation deficiencies and communicates with providers when clarification is required to support accurate coding and billing.
• Performs charge reconciliation and resolves billing edits.
• Reviews daily work queues to identify missing charges, coding edits, claim rejections, and billing exceptions prior to claim submission.
• Researches and resolves charge discrepancies using the electronic health record (Epic), Optum Claims Manager, encoder software, payer policies, and departmental billing systems.
• Ensures charges are submitted accurately and within established productivity and timeliness standards to minimize claim delays and maximize reimbursement.
• Performs other job-related duties as assigned.

Requirements

• High school diploma or GED.
• Five years of relevant experience.
• Certified Coding Specialist – Physician-based (CCS-P) by the American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC).

Preferred Qualifications

• Anesthesia experience.

This position is not eligible for visa sponsorship. Candidates must be legally authorized to work in the United States at the time of application and throughout the duration of employment.