JOB DESCRIPTION Summary
The PB Coding Analyst I is responsible for accurate coding of professional services, primarily office-based evaluation and management (E/M) visits, using CPT, HCPCS, and ICD-10-CM coding systems. This role supports compliance, revenue integrity, and timely claim submission.
Educational Requirements
- High school diploma or equivalent required
- Coding certification preferred (CPC, CCS-P, or equivalent)
Knowledge/Skills/Abilities
- 0-1 year of coding experience or relevant training preferred
- Basic knowledge of:
- E/M coding guidelines
- ICD-10-CM diagnosis coding
- CPT procedure coding
- Strong attention to detail and organizational skills
- Must be able to communicate effectively in English, both verbally and in writing
- Ability to work independently and as part of a team
Physical Requirements
- Vision acuity, hearing sensitivity, and manual dexterity
- Occasional bending, stooping, kneeling, reaching, lifting, and standing
Key Responsibilities
- Assign accurate CPT, HCPCS, and ICD-10-CM codes for:
- Office and outpatient E/M services
- Basic in-office procedures (e.g., minor procedures, injections, simple diagnostics)
- Review provider documentation to ensure coding accuracy and completeness
- Ensure compliance with payer guidelines, CMS regulations, and organizational coding policies
- Identify and communicate documentation deficiencies to providers or leadership
- Assist with charge capture, coding audits, denials, and appeals
- Maintain a 95% or higher accuracy rating and demonstrate a consistent level of performance, keeping up with industry standards of charts per hr. per area of specialty
- Stay current with coding updates and regulatory changes
- Provide feedback and education to providers on documentation improvement
- Other tasks and responsibilities as assigned