Day-to-Day Responsibilities
• Review and code professional fee encounters using ICD-10-CM, CPT, and HCPCS guidelines.
• Assign accurate E/M levels, diagnoses, and procedure codes to ensure compliant reimbursement.
• Abstract key patient and encounter data for billing, regulatory, and reporting purposes.
• Audit medical records to ensure documentation supports services billed and identify documentation gaps.
• Communicate with physicians and providers to obtain coding and documentation clarifications.
• Review and resolve coding-related claim edits, including medical necessity and NCCI/CCI edits.
• Collaborate with billing and Accounts Receivable teams to resolve coding and reimbursement issues.
• Maintain quality and productivity standards while meeting a 95% coding accuracy requirement.
• Work within EMR, hospital information systems, and encoder software in a fully remote environment.
Stay current on coding regulations, payer requirements, and continuing education requirements.
We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com.To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.
Required Skills & Experience
• 3+ years of Professional Fee (Pro-Fee) Coding experience.
• Active coding certification through AAPC or AHIMA.
• Active RHIT, RHIA, CPC, COC, CCS-P, CCS, CEDC, or equivalent coding credential.
• Experience coding clinic visits/professional services.
• Strong experience with Evaluation & Management (E/M) coding, diagnosis coding, injections, and procedure coding.
• Strong knowledge of ICD-10-CM, CPT, HCPCS, modifiers, and coding compliance guidelines.
• Experience with Cerner EMR.
• Experience working remotely.
• Proficiency in Microsoft Outlook, Excel, and Teams.
Strong communication, organization, and multitasking skills.
Nice to Have Skills & Experience
• Emergency Department (ED) coding experience.
• Multi-specialty Pro-Fee coding background.
• Experience with regulatory reporting and data abstraction.
• Prior hospital or health system coding experience.
• Experience partnering with AR/billing teams on claim resolution.
• History of exceeding coding productivity and quality metrics.
• Experience mentoring, training, or educating other coders.
Additional AAPC or AHIMA certifications beyond minimum requirements.
Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.