Gastroenterology ProFee Coder, E/M & Surgical
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Job Description
Remote ProFee Coder focusing on gastroenterology coding for healthcare services. Responsible for accurate coding of diagnosis and procedures adhering to compliance standards.
Responsibilities:
- Review provider documentation, including office notes, inpatient progress notes, consults, and operative reports, to accurately assign professional fee CPT and ICD-10-CM codes
- Code E/M services (office, inpatient, consults, observation, and procedures) in compliance with current AMA and CMS guidelines
- Code physician-performed gastroenterology procedures, including endoscopic and surgical services (EGD, colonoscopy, sigmoidoscopy, ERCP, etc.)
- Apply appropriate ProFee modifiers (e.g., -25, -26, -57, -59, -51) based on documentation and payer rules
- Ensure correct identification of global surgical periods and physician responsibilities within those periods
- Validate medical necessity and linkage of diagnoses to procedures for professional claims
- Identify documentation gaps and communicate with providers or CDI teams to ensure accurate ProFee coding
- Assist with claim edits, denials, and coding-related inquiries for professional services
- Maintain productivity, accuracy, and quality benchmarks for ProFee coding
Requirements:
- High school diploma or equivalent (required)
- Completion of an accredited medical coding program or equivalent experience
- 2+ years of ProFee gastroenterology coding experience preferred
- Experience with physician billing systems and EHR platforms
- CPC, CCS-P, or equivalent professional coding certification preferred
- Specialty certification in gastroenterology coding (e.g., CGSC) preferred
Benefits:
- Full health insurance including medical/dental/vision
- PTO
- 401k match
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