[Hiring] Health Information Management Professional Physician Practice Coder @Rome Health

Role Description

The Professional/Physician Practice Coder reviews clinical documentation and accurately assigns ICD-10-CM, CPT, and HCPCS codes for physician and other professional services. This position ensures coding is complete, accurate, and compliant with official coding guidelines, payer requirements, Medicare regulations, and organizational standards. The Coder collaborates with providers to clarify documentation, supports coding reviews and appeals, identifies documentation or workflow trends, and meets established productivity and quality standards.

• Reviews professional and physician practice documentation and accurately assigns ICD-10-CM, CPT, and HCPCS codes, modifiers, and other required billing information.
• Ensures coding complies with official coding guidelines, Medicare regulations, payer requirements, National Correct Coding Initiative edits, and organizational policies.
• Verifies encounters are complete and identifies missing documentation, charges, diagnoses, procedures, or other information required for accurate coding and billing.
• Submits documentation clarification queries to providers when information is incomplete, conflicting, ambiguous, or insufficient to support code assignment.
• Assists providers with documentation and coding questions while maintaining coding integrity and compliance.
• Works with the Business Office and other departments to resolve coding edits, claim denials, charge corrections, and problem or aging encounters.
• Reviews coding worklists and promptly addresses incomplete, suspended, or unresolved encounters.
• Meets or exceeds established coding accuracy, quality, and productivity standards.
• Maintains current knowledge of CPT, ICD-10-CM, HCPCS, modifiers, Medicare requirements, payer policies, and regulatory changes.
• Maintains all required professional coding credentials and completes continuing education requirements.
• Participates in peer reviews, coding audits, education, cross-training, and training of new team members as requested.
• Identifies recurring documentation, coding, technology, or workflow concerns and promptly reports trends to the Coding Manager.
• Protects patient confidentiality and complies with HIPAA, departmental policies, and organizational standards.
• Provides coverage for other coding functions within the professional and physician practice coding area as needed.
• Performs other related duties and special projects as assigned.

Qualifications

• High school diploma or equivalent required.
• Current RHIA, RHIT, CCS, CCA, or CPC credential required.
• Knowledge of professional and physician practice coding, including ICD-10-CM, CPT, HCPCS, modifiers, and applicable coding guidelines.
• Knowledge of medical terminology, anatomy, physiology, and basic healthcare reimbursement principles.
• Knowledge of Medicare regulations, payer requirements, and National Correct Coding Initiative edits.
• Demonstrated critical-thinking, analytical, organizational, and problem-solving skills.
• Ability to interpret clinical documentation and assign accurate, compliant codes.
• Ability to maintain accuracy and productivity while managing multiple priorities and deadlines.
• Proficiency in electronic health records, coding and billing applications, email, telephone systems, and standard computer software.
• Ability to work independently in a remote environment after successfully completing training.
• Ability to maintain patient confidentiality and comply with HIPAA and organizational policies.
• An associate's or bachelor's degree in health information management or a related field is preferred.
• Previous professional or physician practice coding experience is also preferred.

Requirements

• This position requires prolonged periods of sitting and working at a computer, with frequent use of a keyboard, mouse, telephone, and other standard office equipment.
• The employee must be able to perform repetitive hand, wrist, and finger movements associated with data entry and visually review detailed electronic health records, reports, and coding information for extended periods.
• The position also requires effective communication by telephone, email, virtual meetings, and other electronic systems.
• The employee may occasionally be required to stand, walk, bend, reach, and lift or carry office materials weighing up to 10 pounds.
• The employee must be able to perform the essential functions of the position with or without reasonable accommodation.

Benefits

• Comprehensive benefits package including medical, dental, and vision coverage.
• Health Savings Account (HSA).
• 403(b) retirement plan with company match.
• Group and voluntary life and AD&D insurance.
• Supplemental coverage through Aflac.
• Employee discounts and perks programs.