Specialty Coder – Orthopedics

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

📋 Description

• Accurately assign and properly sequence ICD-10 and CPT codes along with all relevant modifiers.

• Reach out to clients when the documentation in the medical record is insufficient, ambiguous, or unclear for coding purposes.

• Keep abreast of regulatory and payer changes as they pertain to diagnostic and procedure coding.

• Investigate and resolve coding-related system edits, payer rejections, and insurance denials.

• Recognize trends in system edits, payer rejections, and insurance denials to enhance client policies and procedures.

• Stay informed about current coding practice changes through continuing education and resource material review.

• Perform other innovative and forward-thinking duties as assigned.

⛳️ Requirements

• Active credentials such as CPC, COC, or CCS-P (coding certification must align with the role).

• A minimum of 3 years of experience in orthopedic physician coding.

• Proficiency in charge entry and resolving coding-related denials.

• Experience with eClinicalWorks is preferred.

• Familiarity with orthopedic surgery, office visits, imaging, and musculoskeletal procedures is preferred.

• Experience with coding audits, second-level reviews, and coder coaching is preferred.

• Knowledge of denial management, payer policy research, and appeals support is preferred.

• Strong understanding of ICD-10-CM, PCS, CPT, HCPCS, modifiers, and E/M guidelines.

• Experience with encoder/grouper tools, EHR workflows, and claim edit concepts (e.g., NCCI).

• Ability to code without encoder/grouper tools.

• Working knowledge of HIPAA, documentation standards, and audit expectations.

• Capability to work independently in a remote, metric-oriented environment.

🏝️ Benefits

• Access to a 401(k) Retirement Savings Plan.

• Comprehensive Medical, Dental, and Vision Coverage.

• Paid Time Off.

• Paid Holidays.

• Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services.