Coder II

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Conduct thorough reviews of medical records and assign ICD-10 and CPT codes in accordance with relevant policies and regulations.

• Oversee patient demographics, clinical documentation, and billing information across practice management systems and hospital records.

• Ensure accurate coding and reimbursement for both scheduled and unscheduled surgical procedures.

• Abstract data in alignment with national, regional, and local guidelines.

• Analyze and review medical record documentation to accurately assign ICD-10 diagnosis and CPT procedure codes.

• Utilize the practice management system to manage demographics and services performed, following standard procedures and coding guidelines.

• Employ individual hospital medical record systems and collaborate with physicians and staff to gather clinical documents and demographics necessary for coding and billing.

• Offer education and support to clinical areas regarding the proper documentation and coding of services.

• Maintain effective communication with providers regarding coding issues.

• Resolve coding edits or discrepancies in documentation and escalate complex or uncertain cases as needed.

• Work in partnership with providers, Coding leadership, Authorization, Revenue Cycle, and other operational teams.

⛳️ Requirements

• High school diploma/GED or equivalent knowledge is preferred.

• Certification by the American Health Information Management Association (CCS-P) or the American Academy of Professional Coders (CPC) is required.

• 3-5 years of medical coding experience is preferred, ideally in a multi-specialty environment.

• Experience in orthopedics, surgery, pain management, spine, or other complex procedural coding is preferred.

• Familiarity with reviewing operative reports and clinical documentation is essential.

• Proficient in assigning accurate CPT, ICD-10-CM, HCPCS, and modifiers.

• Experience in resolving coding edits or discrepancies in documentation is necessary.

• Background in coding audits, payer guidelines, NCCI edits, and physician queries is strongly preferred.

• A current professional coding certification such as CPC, CCS, COC, or equivalent is preferred/required based on organizational standards.

• Extensive knowledge of CPT, ICD-10-CM, HCPCS Level II, modifiers, NCCI edits, global surgical guidelines, and payer-specific coding requirements.

• Ability to interpret complex operative reports and select codes based on documented procedures effectively.

• Strong research, analytical, and problem-solving abilities.

• Keen attention to detail and a commitment to coding accuracy and compliance.

• Effective written and verbal communication skills.

• Capability to communicate coding concerns, request documentation clarification, and collaborate with providers and operational teams.

• Ability to work independently with minimal supervision.

• Skill in managing a consistent coding workload while meeting productivity and accuracy standards.

• Ability to escalate complex or uncertain cases as appropriate.

• Proficient in recognizing documentation deficiencies and identifying potential compliance issues.

• Ability to research unfamiliar procedures and consistently apply coding guidelines.

• Flexibility to adapt to multiple specialties and changing payer requirements.

• Sound judgment, accountability, organization, critical thinking, and the ability to prioritize competing demands.

• Equal Opportunity Employer.

🏝️ Benefits

• Comprehensive benefits package including medical, dental, and vision plans.

• 100% employer-paid life insurance.

• 401(k) plan with employer match.

• Benefits commence on the first of the month following the hire date (for full-time employees).

• Generous paid sick and vacation leave.

• 7 paid holidays each year.

• Opportunities for professional growth and advancement.

• Employee referral reward program.