Professional Coding & Revenue Recovery Coordinator (4382)

Position Summary:

The Professional Coding Quality & Revenue Recovery Coordinator supports accurate professional coding, compliant provider documentation, denial prevention, and revenue recovery across hospital-based and outpatient clinical services. This role evaluates coding and reimbursement issues, provides education to coding staff and providers, and develops strategies to address documentation deficiencies, payer requirements, and preventable denials. The Coordinator collaborates across coding, billing, clinical, and payer teams to strengthen coding quality, regulatory compliance, reimbursement integrity, and the overall encounter-to-billing process.

Key Responsibilities:

• Provide professional coding education and quality guidance to coding staff and providers regarding CPT, HCPCS, ICD-10-CM, evaluation and management coding, NCCI edits, documentation standards, payer requirements, and applicable regulatory updates.
• Perform coding and documentation quality reviews to identify accuracy, compliance, reimbursement, and workflow risks, and develop targeted education and corrective actions based on identified findings.
• Analyze denial, write-off, audit, and reimbursement trends to identify root causes and recommend improvements to documentation, coding, billing, and revenue cycle processes.
• Investigate complex coding and reimbursement denials, prepare well-supported appeals, and coordinate appropriate escalation through payer reconsideration and applicable external review processes.
• Collaborate with physicians, advanced practice providers, coding teams, billing teams, patient representatives, and payers to resolve documentation and reimbursement discrepancies using approved communication and query processes.
• Develop specialty-specific coding resources and communicate emerging coding trends, payer policy changes, denial patterns, and reimbursement risks to support consistent practices and prevent recurring issues.