Remote R1 Rcm Medical Coding Jobs in Middletown, DE

Description

The Professional Fee Coder (ProFee) is responsible for reviewing provider documentation and assigning accurate ICD-10-CM, CPT, and HCPCS Level II codes for physician professional services. This role supports compliant coding, timely charge capture, and clean claim submission in accordance with current AMA, CMS, NCCI, and payer guidelines.

At least three years of recent professional fee coding experience, including direct, recent experience in all of the following areas:

• Inpatient neonatal and NICU coding 
• Pediatric coding 
• Neonatal and pediatric critical care coding 

• Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS Level II codes, and applicable modifiers for professional fee services. 
• Select appropriate Evaluation and Management levels based on current MDM and time guidelines and ensure documentation supports code selection. 
• Apply neonatal critical care, intensive care, newborn care, consultation, modifier, and payer-specific coding guidelines accurately. 
• Apply modifier and global surgery rules and comply with NCCI edits and applicable payer policies. 
• Ensure medical necessity and proper linkage of diagnoses to services and resolve coding edits before claim submission when applicable. 
• Query providers for clarification when documentation is incomplete or ambiguous, following compliant query practices. 
• Meet established productivity, accuracy, and turnaround-time standards. 
• Collaborate with billing and denials teams to resolve coding-related rejections and provide supporting rationale for appeals as needed. 
• Maintain confidentiality and comply with HIPAA and organizational requirements. 
• Stay current with coding guideline updates, payer changes, and professional fee compliance requirements. 
• Participate in internal quality reviews and implement corrective actions to improve coding accuracy. 

• Active Certified Professional Coder certification required. 
• CPC-A will not be considered for this experienced position. 
• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, E/M guidelines, modifiers, NCCI edits, and payer requirements. 
• Proficiency with EHR and coding applications such as Epic, Cerner, 3M, or Optum. 
• Strong attention to detail, analytical skills, and ability to work independently in a remote environment. 
• Effective written and verbal communication skills. 
• CPEDC or CEMC certification preferred but not required. 

PF Concepts is a growing healthcare revenue cycle company committed to quality, integrity, teamwork, and continuous growth. We partner with healthcare organizations to improve financial performance through strong relationships, personalized solutions, and high service standards.

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Paid training
• Tuition reimbursement
• Vision insurance

Selected candidates will be asked to complete a live, closed-resource, job-related coding assessment as part of the interview process. Reasonable accommodations are available upon request. 

Requirements

• Active Certified Professional Coder certification required. 
• CPC-A will not be considered for this experienced position. 
• Strong knowledge of ICD-10-CM, CPT, HCPCS Level II, E/M guidelines, modifiers, NCCI edits, and payer requirements. 
• Proficiency with EHR and coding applications such as Epic, Cerner, 3M, or Optum. 
• Strong attention to detail, analytical skills, and ability to work independently in a remote environment. 
• Effective written and verbal communication skills. 
• CPEDC or CEMC certification preferred but not required.