Certified Medical Coder - Oncology Profee

Overview

The Profee Coder plays a critical role in the healthcare industry by accurately assigning diagnostic and procedural codes to physician services. These codes support billing, reimbursement, and the maintenance of accurate medical records.

The Profee Coder ensures strict compliance with coding guidelines, regulations, and documentation requirements while optimizing reimbursement and minimizing coding errors. This role collaborates closely with healthcare providers, billing teams, and administrative staff to review medical documentation and assign appropriate codes.

Responsibilities

• Code Assignment : Review and analyze medical documentation (patient encounters, operative reports, clinical notes) to assign accurate diagnostic and procedural codes using ICD-10-CM, CPT, and HCPCS.
• Compliance : Ensure adherence to coding guidelines, regulations, and payer-specific policies, including Medicare, Medicaid, LCDs, and NCCI edits.
• Documentation Review : Collaborate with providers to clarify documentation, resolve ambiguities, and obtain additional details as needed.
• Reimbursement Optimization : Assign appropriate Evaluation & Management (E&M) levels, modifiers, and other codes to maximize reimbursement and reflect service complexity.
• Coding Systems : Use coding software, encoders, and EHR systems effectively. Stay updated on coding changes, guidelines, and technology enhancements.
• Training & Education : Maintain current knowledge of coding regulations, guidelines, and industry trends through ongoing education and professional development.
• Collaboration : Partner with billing teams, providers, and administrative staff to resolve coding issues, address denials, and provide expertise.

Required Qualifications

Job Description

Seniority level

Employment type

Job function

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