Remote Medical Coder - Pulmonology / Hematology-Oncology (ProFee)

Employment Duration: 3 Months (w/ potential for extension)
Workplace: Remote - Fully Off-Site
Schedule: Full-Time, Day Shift
Department: Faculty Practice Revenue Management Operations (FPRMO)
Salary Range: $50.61-$63.01/hour

The Medical Coder fulfills a role supporting UCSF's physician practices. The position reviews patient records, discharge summaries, operative reports, and other clinical documentation to assign standardized codes for diagnoses, procedures, and services. The role applies national and international coding classifications to ensure records reflect the care delivered, supporting accurate reimbursement and reliable clinical data.

The position requires knowledge of Current Procedural Terminology (CPT), International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), and Healthcare Common Procedure Coding System (HCPCS). The role operates within a healthcare records or billing team and requires close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries. Coders must maintain currency with coding updates, compliance requirements, and professional standards and participate in regular audits to monitor coding quality. Expectations include timely processing of case volumes while maintaining high accuracy, adherence to confidentiality and information governance standards, and contribution to process improvements that enhance data quality and coding efficiency.

The Faculty Practice Revenue Management Operations department is responsible for physician-based coding for UCSF faculty. The team ensures accurate code assignment for professional services delivered across UCSF locations, affiliated community hospitals, off-license practices, and ambulatory clinics. FPRMO supports physicians, nurse practitioners, and advanced practice providers across specialties including Neurosurgery, Cardiovascular services, OB/GYN, Gender Reassignment, Rheumatology, and Plastic Surgery. The department provides precise and compliant coding for approximately 1.6 million patient encounters annually, supporting regulatory requirements and optimal reimbursement.

Key Responsibilities:

• Work in moderate work queues daily as defined by UCSF Leadership.
• Work in simple work queues as needed.
• Work RFI and edit work queues as needed.
• Maintain or exceed a 95% accuracy rate.
• Maintain productivity standards as defined by UCSF Leadership.
• Work proactively with divisions in areas of specialization to assure appropriate revenue cycle practices and compliance with internal and external regulations.
• Code intermediate procedures/accounts that require advanced knowledge in charge capture, workflow, hospital operations, authorizations, and revenue cycle.
• Resolve Claims Manager and Epic edits to ensure correct coding of services provided, including review of documentation for correct coding and E/M leveling, diagnosis coding, bundling issues, and modifier usage.
• Apply dashboards and processes for continuous analysis of moderate revenue cycle functions of diverse scope. Audit data input to support revenue cycle management.
• Complete other coding working reports, reconcile charge lists, create charge sessions, update DEPs, and follow up on credential requests.
• Perform verification and correction of statistical data abstracted and compiled by lower-level staff, reconciliation of output statistics, and medical coding.
• Review APeX PB Charge Edit and RFI work queues daily/as assigned, address inquiries from payors that require department review, and resolve claim edits to ensure timely billing.
• Proactively review assigned work queues and reach out to faculty and ancillary providers for necessary documentation changes and updates.
• Run necessary reports related to moving assigned charges through their respective work queues, including missing charge reports, error reports, and other reports related to charge capture, error resolution, and throughput.
• Under supervision, analyze charge integrity, reconciliation, and charge linkages from ancillary charging systems for the medical center/health system.

N/A

Required Qualifications:

• 2-5 years of professional fee/revenue cycle coding experience or equivalent experience/training.
• Hands-on coding experience in Pulmonary procedures OR Hematology/Oncology procedures.
• Epic/APeX experience.
• Intermediate knowledge of medical terminology, CPT, ICD-10 coding conventions, and clinical documentation requirements.
• Knowledge of federal, state, and commercial payer coding and billing standards.
• Prior healthcare experience.
• Strong analytical, problem-solving, communication, and collaboration skills.
  

Required certification/licensure:

• CPC, CCS-P, CCA, CCS, RHIT, RHIA, or equivalent licensure approved by FPRMO management.

Preferred Qualifications:

• Secondary coding certification such as Certified Interventional Radiology Coder (CIRC), Certified Emergency Department Coder (CEDC), or equivalent.

Required Qualifications:

• 2-5 years of professional fee/revenue cycle coding experience or equivalent experience/training.
• Hands-on coding experience in Pulmonary procedures OR Hematology/Oncology procedures.
• Epic/APeX experience.
• Intermediate knowledge of medical terminology, CPT, ICD-10 coding conventions, and clinical documentation requirements.
• Knowledge of federal, state, and commercial payer coding and billing standards.
• Prior healthcare experience.
• Strong analytical, problem-solving, communication, and collaboration skills.
  

Required certification/licensure:

• CPC, CCS-P, CCA, CCS, RHIT, RHIA, or equivalent licensure approved by FPRMO management.

Preferred Qualifications:

• Secondary coding certification such as Certified Interventional Radiology Coder (CIRC), Certified Emergency Department Coder (CEDC), or equivalent.