OP Ancillary/Physician Coder 26-00053

Under the direction of the Coding Compliance Manager, the OP Ancillary/Physician Coder plays a key role in reviewing and analyzing billing and coding for charge processing. This position is responsible for accurately reviewing and coding office, hospital, and surgical procedures to ensure compliant reimbursement. The coder will assign and sequence appropriate ICD-10-CM, CPT, and HCPCS codes for inpatient and outpatient services, diagnostic tests, and other medical services rendered.

This is a ProFee coding-only role (no HCC coders) with a strong emphasis on diagnostic radiology coding and bundling rules.

Essential Duties & Responsibilities

• Analyze and interpret medical records to assign accurate ICD-10-CM, CPT, and HCPCS codes

• Review and code office, hospital, inpatient, outpatient, and surgical procedures

• Follow established workflows for claim denials and work Follow-Up work queues

• Identify billing/coding improvement opportunities and analyze denial trends

• Participate in coding compliance monitoring and clinical documentation improvement initiatives

• Perform monthly provider coding change analysis and educate providers as needed

• Work weekly Missing Charge Reports to identify missed billable charges

• Maintain productivity and quality standards established by management

• Collaborate with Physician Billing Services, Insurance, and Customer Service teams

• Ensure compliance with organizational policies and coding regulations

• Maintain patient confidentiality and professional conduct at all times

• Minimum 3 years of experience in a hospital or physician office setting as a medical coder

• Experience interacting directly with physicians

• Expert knowledge of ICD-10, CPT, and HCPCS

• Strong understanding of medical terminology, anatomy, and physiology

• Solid knowledge of the healthcare revenue cycle

• EPIC experience required

• Proficient in Microsoft Office

• Strong analytical, critical thinking, and problem-solving skills

• Excellent written and verbal communication skills

• Detail-oriented, dependable, and professional

Hard Requirements

• Must reside in California

• Minimum 3 years of physician/professional fee coding experience

• Strong expertise in diagnostic radiology coding and bundling rules

• Radiology coding experience required

• Knowledge of charge submission within EPIC

• ProFee coding experience only (No HCC coders)

• Active CPC, CCS, or equivalent certification (AAPC or AHIMA)