Orthopaedic Coding & Precertification Manager

Description

At Barbour Orthopaedics & Spine, we're building one of the premier musculoskeletal care organizations in the Southeast. With a growing network of orthopaedic surgeons, spine specialists, sports medicine physicians, advanced practice providers, ambulatory surgery centers, imaging services, and rehabilitation programs, we are seeking a high-performing to help optimize reimbursement, strengthen compliance, and lead our coding and authorization operations.

This is an opportunity for a revenue cycle leader who understands the complexities of orthopaedic surgery, outpatient coding, payer authorizations, and ASC operations, and who thrives in a fast-paced, growth-oriented environment.

If you're a Leader with a strong coding background and a passion for improving financial performance while supporting exceptional patient care, we want to hear from you.

• Growing multi-state orthopaedic platform
• Opportunity to lead and build high-performing teams
• Direct impact on revenue cycle performance and organizational growth
• Collaborative partnership with surgeons, executives, and operational leaders
• Competitive compensation, bonus potential, and comprehensive benefits
• Career advancement opportunities within a rapidly expanding organization

The Orthopaedic Coding & Precertification Manager is responsible for the strategic leadership and day-to-day management of orthopedic coding, surgical precertification, denial prevention, documentation integrity, and revenue optimization initiatives across physician practice and ambulatory surgery center operations.

The ideal candidate combines deep expertise in orthopedic surgical coding, outpatient reimbursement, payer authorization requirements, and revenue cycle operations with proven leadership experience developing high-performing teams and driving measurable financial outcomes.

This role serves as a critical business partner to physicians, ASC leadership, surgery scheduling teams, finance, and revenue cycle stakeholders.

• Ensure accurate coding of orthopedic procedures, including:
  • Joint Replacement
  • Sports Medicine
  • Arthroscopy
  • Spine Surgery
  • Fracture Care
  • Trauma
  • Injection Procedures
  • Hand and Upper Extremity Services
• Maintain compliance with CPT, HCPCS, ICD-10-CM, CMS, NCCI, and payer requirements.
• Provide coding guidance related to modifier usage, laterality, global surgical packages, and medical necessity requirements.
• Conduct coding audits and provider education programs to improve documentation quality and coding accuracy.

• Oversee all surgical and procedural authorization workflows.
• Ensure timely authorization approvals to prevent surgical delays and avoidable denials.
• Develop efficient authorization processes that improve patient access and reimbursement outcomes.
• Monitor payer-specific requirements and proactively address authorization challenges.

• Partner with billing teams to improve clean claim rates and reduce reimbursement delays.
• Monitor and resolve:
  • Authorization discrepancies
  • Charge lag
  • Coding edits
  • Clearinghouse rejections
  • Unbilled claims
• Identify and implement opportunities for revenue enhancement and revenue leak prevention.

• Analyze coding-related and authorization-related denials.
• Develop corrective action plans and sustainable process improvements.
• Lead appeal efforts involving medical necessity, coding compliance, authorization disputes, and bundling issues.
• Present denial trends and financial impact analyses to leadership.

• Manage coding…