Job Description

Summary

The PB Coding Analyst II is responsible for accurate coding of simple and advanced professional services, including complex E/M visits and surgical procedures using CPT, HCPCS, and ICD-10-CM coding systems. This role requires strong knowledge of coding guidelines, anatomy, and operative report review to ensure accurate code assignment and optimal reimbursement. This role supports compliance, revenue integrity, and timely claim submission.

Educational Requirements

• High school diploma or equivalent required
• Coding certification preferred (CPC, CCS-P, or equivalent)

Knowledge/Skills/Abilities

• 1-2 years of professional coding experience preferred
• Prior experience with surgical coding and operative reports
• Strong knowledge of:
• E/M coding (including risk-based MDM)
• ICD-10-CM diagnosis coding
• CPT procedure coding
• Surgical CPT coding across one or more specialties
• Modifier usage and NCCI guidelines
• Medical terminology, anatomy, and surgical procedures
• Strong attention to detail and organizational skills
• Must be able to communicate effectively in English, both verbally and in writing
• Ability to work independently and as part of a team

Physical Requirements

• Vision acuity, hearing sensitivity, and manual dexterity
• Occasional bending, stooping, kneeling, reaching, lifting, and standing

Key Responsibilities

• Assign accurate CPT, HCPCS, and ICD-10-CM codes for:
• Office and outpatient E/M services
• Complex and specialty-specific procedures
• Surgical procedures from operative reports
• Review and interpret operative notes to determine correct coding, including:
• Procedure selection
• Modifier assignment (e.g., 22, 25, 50, 51, 59, etc.)
• Ensure compliance with NCCI edits, payer policies, and CMS guidelines, and organizational coding policies
• Identify opportunities for coding optimization while maintaining compliance
• Assist with charge capture, coding audits, denials, and appeals
• Maintain a 95% or higher accuracy rating and demonstrate a consistent level of performance, keeping up with industry standards of charts per hr. per area of specialty
• Stay current with coding updates and regulatory changes
• Provide feedback and education to providers on documentation improvement
• Other tasks and responsibilities as assigned