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The PB Anesthesia Coder is a specialty coding professional responsible for the accurate, complete, and timely coding of anesthesia services within Healthrise’s Physician Billing (PB) coding operation. This role applies current CPT, ASA Relative Value Guide, and ICD-10-CM coding standards to anesthesia charges – including base and time unit calculation, qualifying circumstances, and medical direction/supervision modifiers – to ensure charges are coded correctly the first time and released for billing without unnecessary delay. Working within Epic PB Charge Review and associated coding work queues, this individual reviews anesthesia documentation for completeness, resolves charge edits and missing information holds, and partners with providers, CRNAs, and clinical documentation teams to close gaps that would otherwise stall charge posting. The role is central to keeping anesthesia charge inventory current, preventing aged/unposted batches, and protecting revenue integrity for the anesthesia service line across supported client engagements. This is a part-time, ongoing position is well suited to an experienced anesthesia coder who wants focused, high-value specialty work. The role offers direct exposure to Healthrise’s RCM Services coding leadership and consulting teams, with the opportunity to expand into additional service lines or a broader PB coding caseload as volume and business need evolve.

Anesthesia Charge Coding & Compliance

• Knows, understands, incorporates, and demonstrates the Healthrise Core Values in all interactions with team members, clients, and stakeholders.

• Codes anesthesia professional services in accordance with current CPT, ASA Relative Value Guide (RVG), and ICD-10-CM guidelines, including accurate assignment of base units, time units, and qualifying circumstances.

• Applies correct anesthesia modifiers (e.g., AA, QK, QX, QY, QZ) to reflect medical direction, medical supervision, and CRNA involvement in accordance with payer-specific and CMS billing rules.

• Reviews anesthesia records, surgical case documentation, and CRNA/anesthesiologist notes to validate start/stop times, procedure correlation, and documentation sufficiency to support the level and units billed.

• Identifies and resolves discrepancies between operative/anesthesia documentation and charge capture prior to release, escalating true documentation gaps to providers for query and clarification.

Charge Review & Work Queue Management (Epic)

• Works assigned Epic PB Charge Review work queues daily, prioritizing aging anesthesia charge batches to prevent unposted-charge backlog and DNFB (Discharged Not Final Billed) exposure.

• Resolves charge edits, coding-related holds, and missing-charge-information flags within established turnaround-time and productivity standards.

• Monitors and reports on unposted anesthesia batch volume and aging, flagging systemic issues (e.g., interface errors, recurring documentation gaps) to coding leadership.

• Coordinates with Epic optimization and revenue cycle systems teams on charge routing, work queue configuration, and recurring edit patterns affecting anesthesia coding throughput.

Quality, Compliance & Documentation Integrity

• Maintains coding accuracy and productivity at or above departmental quality benchmarks, consistent with AAPC/AHIMA coding standards and Healthrise coding quality assurance program requirements.

• Ensures all coding activity complies with CMS guidelines, National Correct Coding Initiative (NCCI) edits, payer-specific anesthesia billing policies, and HIPAA privacy and security standards.

• Participates in coding quality audits and provider education initiatives, incorporating audit feedback to continuously improve coding accuracy.

• Stays current on annual CPT/ICD-10-CM code set updates, ASA base unit changes, and payer policy changes affecting anesthesia coding and reimbursement.

Cross-Functional Collaboration & Communication

• Partners with denial management and AR teams to research and resolve anesthesia-specific coding denials, underpayments, and payer edits.

• Communicates coding trends, backlog status, and documentation gaps to coding leadership and client stakeholders in a clear, timely manner.

• Supports onboarding and knowledge transfer for new anesthesia coding resources, including offshore/remote team members, as coding capacity scales.

• Performs other duties as assigned.

Required

• High school diploma or equivalent required; associate’s degree or coursework in health information management, medical coding, or a related field preferred.

• Active anesthesia coding credential from AAPC or AHIMA - Certified Anesthesia and Pain Management Coder (CANPC), Certified Professional Coder (CPC) with demonstrated anesthesia specialty experience, or equivalent.[KL1] 

• Minimum 2 years of hands-on anesthesia coding experience, including base/time unit calculation, ASA crosswalk application, and medical direction/supervision modifier assignment.

• Working knowledge of CPT, ICD-10-CM, ASA Relative Value Guide, NCCI edits, and CMS/payer-specific anesthesia billing and reimbursement rules.

• Hands-on experience with Epic PB Charge Review and coding work queues, or comparable EMR/PM charge coding platforms.

• Strong attention to detail and ability to independently research and resolve charge edits and documentation discrepancies.

• Solid understanding of HIPAA privacy and security requirements as applied to coding and charge review activities.

• Proficiency in Microsoft Office (Outlook, Word, Excel).

• Completion of regulatory/mandatory certifications as required; maintains active credential in good standing through required continuing education.

Preferred

• AHIMA Certified Coding Specialist – Physician (CCS-P) or additional multi-specialty coding credential.

• Epic Charge Review or Professional Billing certification.

• Experience coding for multi-facility or multi-client RCM/BPO environments.

• Experience working within remote, hybrid, or offshore coding team structures.

• Exposure to AI-assisted coding tools, computer-assisted coding (CAC) platforms, or automated charge-edit workflows.

• Familiarity with HFMA revenue cycle standards and denial prevention best practices as applied to anesthesia billing.