Certified Professional Coder (CPC) in Milford, Delaware at Adelfi Medical Billing Solutions

Adelfi Medical Billing Solutions is a fully remote revenue cycle management firm serving 65+ healthcare practices, mostly in New York and New Jersey. Our clients include ambulatory surgery centers and practices in orthopedics, podiatry, vascular surgery, neurosurgery, physical therapy, and chiropractic. We specialize in complex reimbursement, including out-of-network billing and IDR arbitration, where accurate coding directly drives results.

We’re looking for an experienced, detail-driven Certified Professional Coder to join our coding team. You’ll code surgical and office encounters accurately, keep claims moving through charge entry, and resolve front-end rejections before they become denials.

What You’ll Do

Coding

Code operative reports for surgical procedures, including orthopedic, podiatric, vascular, and spine cases, using CPT, HCPCS, and ICD-10-CM.
Code office visits and E/M services using current guidelines based on medical decision-making or time.
Apply modifiers correctly, including 25, 59/XS, 51, 79, 78, RT/LT, TA–T9, and F1–FA, and follow NCCI edits, MUEs, and bundling rules.
Track surgical global periods and code post-op and unrelated services appropriately.
Assign ICD-10-CM codes to the highest level of specificity supported by documentation.
Query providers clearly and compliantly when documentation is incomplete, unclear, or doesn’t support the services billed.
Review provider-selected codes and flag discrepancies before claims are submitted.

Charge and Demographic Entry

Enter charges accurately in the practice management system, including CPT, diagnosis, modifiers, units, place of service, and rendering and referring providers.
Enter and update patient demographics and insurance information, and verify eligibility when needed.
Reconcile charges against surgery schedules and appointment lists so no services are missed.

Rejections and Claim Resolution

Work clearinghouse and payer rejections daily, correct errors, and resubmit claims promptly.
Research and resolve claim edits related to coding, modifiers, demographics, and payer requirements.
Support the AR and denials teams on coding-related denials, including corrected claims and coding appeal language.
Identify recurring coding and rejection trends and recommend fixes to prevent them.

Quality and Compliance

Support internal coding audits and help maintain accuracy standards.
Stay current on CPT, ICD-10-CM, HCPCS, CMS, and payer policy updates.
Support accurate code assignment for out-of-network and IDR claims, where coding accuracy is critical.
Follow HIPAA and compliance standards in all work.

Requirements

Current CPC credential through AAPC is required.
A minimum of 5 years of professional coding experience is required.
Strong experience coding operative reports and office visits.
Thorough knowledge of CPT, HCPCS, ICD-10-CM, modifiers, NCCI edits, and global surgical periods.
Experience with charge entry, demographic entry, and working clearinghouse and payer rejections.
Ability to write clear, compliant provider queries.
Highly accurate, organized, and able to meet daily productivity and quality standards.
Reliable internet and a quiet, private, HIPAA-compliant workspace.

Preferred

Specialty credentials such as COSC (orthopedic), CPCO, or CASCC.
Experience coding orthopedic, podiatry, vascular, spine, or ASC cases.
Experience in eClinicalWorks (ECW) or ModMed.
Experience working for a billing company with multiple clients.
Familiarity with out-of-network billing and the No Surprises Act.

What We Offer

$30–$35/hour, based on experience and credentials.
Medical, dental, and vision benefits.
401(k).
Paid time off.
Fully remote work.

To Apply

Submit your resume along with:

Your CPC credential number and expiration date.
A brief summary of your coding experience, including the specialties you’ve coded and your experience with operative reports.

Applicants without a current CPC credential and 5+ years of coding experience will not be considered.