Medical Coding Specialist – Orthopedic & Neurosurgery

This is a remote position

We are seeking a highly motivated and dedicated coding professional to join our team. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties, with a focus in orthopedic surgeries, as well as E/M. The position requires one to be resourceful, organized, and extremely driven.
The ideal candidate will bring deep expertise in surgical and outpatient coding, strong knowledge of payer guidelines, and proven experience working with denials related to orthopedic and neurosurgical services.

Key Responsibilities:

• Resolve Claim Edits and Denials
  by reviewing clinical documentation, identifying root causes, correcting coding or modifier issues, and submitting appeals or corrected claims as needed.
• Review and Assign Accurate CPT, ICD-10-CM, and HCPCS Codes
  for orthopedic and neurosurgical procedures, including inpatient and outpatient surgeries and office visits.
• Analyze and Code Surgical Cases
  using detailed operative reports, ensuring adherence to coding guidelines, NCCI edits, payer policies, and documentation standards.
• Evaluate Office Visit Documentation
  to confirm appropriate E/M levels and ensure documentation supports the billed services.
• Use Coding and Billing Systems
  such as encoder software, EMRs (e.g., Epic, Cerner), and billing platforms to perform daily work efficiently and accurately. Also the ability to code surgical cases without an encoder, using book and/or Codify.
• Stay Informed on Coding Updates and Compliance Standards
  through continuous education and participation in relevant training or webinars.

• Required Certifications:
  CPC, CCS, or equivalent coding credential (AAPC or AHIMA)
• Experience:
  • Minimum 5 years of medical coding experience in a professional or facility setting
  • At least 2 years of experience specifically coding orthopedic and neurosurgery services
  • Proven experience managing claim denials and coding-related edits
  • Experience in Athena is preferred
• Knowledge & Skills:
  • In-depth knowledge of CPT, ICD-10-CM, HCPCS, modifiers, and medical terminology
  • Strong understanding of NCCI edits, payer-specific billing rules, and LCD/NCD guidelines
  • Excellent attention to detail, analytical thinking, and communication skills
  • Ability to work independently and meet productivity and accuracy standards