Lab Coder

Provider centered. Patient focused. Built for what healthcare should be.

We are looking for a dedicated professional who supports our mission through adhering to and perpetuating coding best practices across the clinic organization. This role will be responsible for varying levels of risk adjustment, regulatory compliance and HCC diagnoses

Every role matter - because every person plays a part in the patient’s story, helping deliver care that is connected, consistent, and truly personal.

Position Summary

The Professional Lab Coder is responsible for reviewing, assigning, and validating CPT,HCPCS and ICD-10-CM codes for professional laboratory services in accordance with current coding guidelines, payer policies, and applicable regulatory requirements. This position ensures accurate code assignments, appropriate diagnosis for the lab service performed that supports medical necessity, and compliant claim submission to support timely reimbursement and minimize coding errors, denials, and audit risks.

The Professional Lab Coder collaborates with team manager, and other RCM billing teams to resolve coding discrepancies. Is able to perform research on payer specific requirements and maintain compliance with coding and billing guidelines.

Key Responsibilities

• Review laboratory charge edits and corresponding documentation to determine appropriate professional coding (CPT and ICD-10)
• Assign and validate CPT, HCPCS and ICD-10 codes for laboratory testing.
• Apply current CPT coding guidelines, ICD-10 conventions, NCCI edits, and applicable payer policies.
• Verify medical necessity and appropriate diagnosis to procedure linkage based on provider documentation and payer coverage requirements.
• Identify missing, invalid, or conflicting information that may affect code assignment, medical necessity, or claim processing.
• Review applicable laboratory bundling – unbundling rules, frequency limitations, and modifier requirements.
• Resolve coding-related claim denials, rejections, and reimbursement issues in collaboration with the coding manager and/or other RCM teams
• Maintain current knowledge of annual CPT, HCPCS, ICD-10, and payer policy updates affecting laboratory services
• Provide feedback on edits and denials to the Coding Manager and RCM team to improve system edits and coding workflows
• Assist and participate in the development of laboratory specific educational materials, and automated coding rules as needed
• Maintain confidentiality and compliance with HIPAA requirements and organizational policies

Knowledge, Skills, and Abilities

• Working knowledge of CPT, HCPCS, ICD-10-CM coding guidelines
• Understanding of professional fee laboratory billing and reimbursement requirements
• Familiarity with medical necessity policies NCD/LCDs, NCCI edits, payer specific rules, and claim adjudication
• High attention to detail and commitment to coding accuracy and compliance
• Ability to interpret clinical documentation and apply coding guidelines consistently
• Proficient with EMR (Electronic Medical Record) and practice management systems
• Ability to manage assigned work independently, prioritize workloads and meet established
• productivity and quality expectations
• Effective written and verbal communication skills
• Ability to collaborate with cross-functional teams to resolve coding and billing issues

Education and Experience

• CPC coding certification
• Minimum 2 yrs of medical coding experience in professional laboratory coding preferred
• Experience or familiarity working with AI-assisted coding, clinical documentation technologies
• Experience with Athenahealth and primary care practice operations preferred

What We Value

Trust. Ownership (Together). Compassion. Relentless Progress . These values shape how we show up for patients - and for each other.

If you’re ready to grow, make an impact, and be part of a connected care team, we’d love to connect.

Bookmark Medical is committed to a workplace that supports and sustains inclusion and belonging. Bookmark Medical does not discriminate in employment opportunities or practices on the basis of race, color, religion, gender, national origin, age, physical or mental disability, pregnancy, childbirth or related medical conditions, military service obligations, citizenship, sexual orientation, genetic information, or any other characteristic protected by applicable local, state, or federal law