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Professional Coder
HCA Healthcare. Review and assign accurate CPT, HCPCS, and ICD-10-CM codes for professional claims .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in CPT, HCPCS, and ICD-10-CM coding, ensuring compliance with national guidelines and Capital Health policies. Proficient in surgical coding and capable of collaborating effectively with healthcare teams to enhance coding accuracy and productivity.
Highest-signal resume keywords
CPT CodingICD-10-CM CodingHCPCS CodingCertified Professional Coder (CPC)Surgical Coding Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
CPT CodingICD-10-CM CodingHCPCS CodingSurgical CodingMedical TerminologyAnatomy and PhysiologyPathophysiologyCoding GuidelinesE&M CodingDocumentation Review
Soft Skills
Excellent Communication SkillsTeamworkCollaborationAttention to DetailProblem-Solving
Tools & Technologies
Microsoft OutlookMicrosoft WordMicrosoft ExcelMicrosoft PowerPointEMR Systems
Certifications & Qualifications
Certified Professional Coder (CPC)Certified Professional Coder-Apprentice (CPC-A)Certified Coding Specialist-Physician (CCS-P)
Industry Keywords
CPTHCPCSICD-10-CMEvaluation and Management ServicesNational Coding GuidelinesCapital Health PoliciesSurgical Coding GuidelinesProvider DocumentationCoding ConventionsRevenue Integrity
About the role
Key responsibilities & impact- Review and assign accurate CPT, HCPCS, and ICD-10-CM codes for professional claims
- Apply official AMA and CMS coding conventions and rules
- Review procedure documentation and assign ICD-10-CM diagnosis, CPT-4 codes, and modifiers
- Ensure appropriate coding of evaluation and management services
- Review procedure documentation for operating room and complex procedure-room cases
- Validate provider-selected ICD-10-CM diagnosis codes
- Analyze provider documentation for appropriate provider-assigned E&M codes
- Meet or exceed departmental accuracy and productivity standards
- Ensure compliance with national coding guidelines and Capital Health policies
- Review CCI edits, MUE edits, LCD and NCD coverage before chart finalization
- Identify documentation gaps or inconsistencies and escalate when clarification is required
- Collaborate with billing, charge review, and revenue integrity teams
- Address professional coding pre-bill edits promptly
- Serve as a subject matter expert for professional coding
- Foster teamwork and collaboration
- Perform other duties as assigned
Requirements
What you’ll need- High school diploma or equivalent
- Certified Professional Coder-Apprentice (CPC-A), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P) certification required
- Associate's degree in health information management preferred
- Two years' experience in physician coding role preferred
- ICD-10-CM, CPT-4 and HCPCS coding experience preferred
- One year surgical coding experience preferred
- Excellent verbal and written communication skills
- Strong knowledge of surgical coding guidelines
- Knowledge of pathophysiology and disease processes
- Physician coding and Training certification
- Proficient with Microsoft applications including Outlook, Word, Excel, and PowerPoint
- Knowledge of Medical Terminology, Anatomy and Physiology, or Pathophysiology
- Ability to work in an environment using multiple EMR systems
- Ability to work collaboratively with others as well as independently
- Accurate Near Vision, Accurate Far Vision, Minimal Color Discrimination, Accurate Depth Perception, and Accurate Hearing
Benefits
Comp & perks- Medical Plan
- Prescription drug coverage & In-House Employee Pharmacy
- Dental Plan
- Vision Plan
- Flexible Spending Account (FSA)
- Healthcare FSA
- Dependent Care FSA
- Retirement Savings and Investment Plan
- Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
- Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
- Disability Benefits – Long Term Disability (LTD)
- Disability Benefits – Short Term Disability (STD)
- Employee Assistance Program
- Commuter Transit
- Commuter Parking
- Supplemental Life Insurance
- Voluntary Life Spouse
- Voluntary Life Employee
- Voluntary Life Child
- Voluntary Legal Services
- Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
- Voluntary Identity Theft Insurance
- Voluntary Pet Insurance
- Paid Time-Off Program