Multi-Specialty Pro-Fee Medical Coder
Title: Multi-Specialty Pro-Fee Medical Coder (ortho) Location: East Haven, CT Job Description:
About the Role
We are seeking highly experienced Orthopedic Medical Coders with current expertise in orthopedic coding to support a dynamic healthcare organization. This role requires coders who are actively coding orthopedics on a regular basis. The ideal candidate will be fully up to date on current orthopedic coding guidelines and comfortable providing coding feedback and education to orthopedic providers, particularly regarding bundling/unbundling rules, modifier usage, and coding compliance.
Key Responsibilities
Charge Review Work Queues · Review provider-submitted coding in EPIC against clinical documentation · Resolve EPIC edits and recommend coding corrections to departments Claim Edit Work Queues · Review provider-submitted coding and address clearinghouse rejections and claim edits · Recommend appropriate coding corrections based on documentation Follow-Up Work Queues · Review post-bill denials and payer edits · Analyze documentation and recommend coding updates to resolve issues Additional responsibilities include: · Reviewing documentation to ensure coding accuracy and compliance · Working billing and coding edits, denials, and payer requirements · Providing coding guidance and feedback to orthopedic providers and departments Requirements · Minimum 5 years of active, ongoing orthopedic coding experience · Current CPC (AAPC) or equivalent certification through AAPC or AHIMA · Extensive experience coding orthopedic services in POS 11, 21, and 22 · Experience coding in-office procedures and orthopedic surgeries · Strong knowledge of billing edits, clearinghouse edits, and payer denials · Comfortable providing coding feedback and education to providers Preferred Qualifications · CEMC certification · Experience with EPIC · Experience with Medicaid of California guidelines · Multi-specialty coding background Orthopedic Coding Expertise Required Candidates must demonstrate strong experience coding: · Spinal injections / pain management procedures · Open fracture repair · Hand surgery, fracture care, and tendon repairs · Carpal tunnel release · Hardware removal procedures · Neuroplasty · Arthroscopy (shoulder, knee, hip) · Arthroplasty (shoulder, knee, hip) · Joint repairs Why Join Us · Remote work opportunity · Work with a collaborative and highly specialized team · Full suite of benefits for full-time employees · Free CEU opportunities · All equipment supplied