Community Health Systems Professional Services Corporation·Franklin, Tennessee
The specialist is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record, ensuring compliance with regulations and payer policies. This role involves working coding edits, performing audits, and collaborating with internal teams to support coding compliance and accurate reimbursement.
The Remote Physician Pro Fee Coder-Radiology is responsible for reviewing, analyzing, and assigning accurate CPT, HCPCS, and ICD-10 codes for professional fee services documented in the medical record. This role ensures proper sequencing, modifier use, and place-of-service coding in compliance with governmental regulations, third-party payer policies, and corporate standards. The Physician Coder plays a key role in revenue cycle accuracy by identifying documentation gaps, ensuring coding integrity, and working collaboratively with internal teams to support physician coding compliance and reimbursement.
Essential Functions Assigns accurate CPT, HCPCS, and ICD-10 codes for professional services, procedures, diagnoses, and treatments based on provider documentation.
Ensures compliance with governmental regulations, third-party payer policies, and corporate coding protocols, following National Correct Coding Initiative (NCCI) edits, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
Performs coding audits and quality reviews, verifying accuracy of documentation and identifying areas for provider education.
Works coding-related claim edits, holds, and scrubs in the electronic billing system (e.g., Athena Collector), ensuring timely claim resolution and reimbursement.
Collaborates with physicians, revenue cycle teams, and coding education staff, requesting clarification when necessary to ensure optimal documentation and compliance.
Performs edit checks on coded data before transmittal, identifying and correcting errors as needed.
Maintains strict confidentiality of patient records, provider information, and financial data, adhering to HIPAA and corporate compliance policies.
Escalates documentation or coding issues to the coding education team for provider training and improved documentation practices.
Assists in coding-related special projects, ensuring accurate reporting and analysis of coding data for operational improvement.
Performs other duties as assigned.
Maintains regular and reliable attendance.
Complies with all policies and standards.
H.S. Diploma or GED required Associate Degree in Health Information Management, Healthcare Administration, or a related field preferred 2-4 years of experience in physician coding, professional fee coding, or medical billing required Experience with multiple specialties, surgical coding, or high-volume professional fee coding preferred
Strong knowledge of ICD-10, CPT, and HCPCS coding systems for physician/professional fee services. Understanding of modifier usage, place-of-service coding, and payer billing guidelines. Experience with electronic health records (EHR), coding software, and claim processing systems. Ability to identify documentation deficiencies and escalate for provider education. Familiarity with NCCI edits, LCD/NCD guidelines, and medical necessity requirements. Strong analytical and problem-solving skills, ensuring accurate coding and optimal reimbursement. Effective communication and collaboration skills, working with providers, revenue cycle teams, and compliance staff. Licenses and Certifications Certified Coder-AHIMA or AAPC (CPC) required or CCS-Certified Coding Specialist (CCS-P) required or Registered Health Information Technician (RHIT) or (RHIA)
A High School Diploma or GED is required, though an Associate Degree in a related field is preferred, along with 2-4 years of experience in physician or professional fee coding. Candidates must possess strong knowledge of ICD-10, CPT, and HCPCS, and hold a required certification such as CPC or CCS-P.
Market context
Physician roles in Tennessee are typically in steady demand, especially in settings that need licensed clinicians who can support patient care and prescribing workflows. These positions are competitive because employers often look for candidates with the right state licensure, CPR certification, and DPS registration, and this platform’s AI-summarized job requirements and benefits help you review the original posting faster. Before applying, confirm your Tennessee license and prescribing credentials are active and match the posting exactly.
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