Orthopedic Coding Specialist

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Responsible for orthopedic coding and compliance for assigned Orthopedic One providers.

• Orthopedic Coding
  • Review operative notes to code for providers who have A/R support provided by staff not credentialed as CPC.
  • Review NCCI edits to code modifiers for surgeries based on operative reports.
  • May code hospital consults for assigned physicians.
  • Review incomplete charge slips identified by other staff members for missing procedures or coded. Provides team members with information needed to complete charge entry.
• Shares Knowledge / Educates
  • Assist director in educating billable providers on proper use of modifiers and other remedial coding instruction.
  • Reviews various billing sources for orthopedic specific updates and communicates information to the Patient Accounts Department on matters such as insurance guideline changes or precertification requirements.
  • Serve as a resource to management when needed for orthopedic specific coding.
  • Based on assignments, may provide updates to Patient Accounts staff and organization regarding changes in precertification requirements by carrier.
• Customer Service and Communications
  • Communicates with patients, insurance carriers and other outside entities in a professional manner. Identifies solutions and responds professionally to patient concerns, i.e., pleasant tone of voice, courteous language, etc. Uses appropriate grammar and demonstrates tact and diplomacy in patient interactions, by phone and in person.
  • Diffuses negative situations with patients and maintains a pleasant and professional tone during stressful circumstances and heavy workload.
  • Communicates with staff members in a professional, pleasant manner;
    Shares information relevant to work, no gossiping or disparaging remarks, accepts work without complaint or provides reasons why assignment is unmanageable, asks and answers questions related to improving department performance
• Teamwork
  • Willingly provides coverage, volunteers assistance, and maintains workflows within department as needed without direct instruction/supervision.
  • Works cooperatively and refrains from participating in negative conversations.
  • Shares knowledge and insights with co-workers in a constructive manner.
  • Works to solve problems and address conflicts with appropriate person directly before involving leadership or uninvolved peers.
  • Is considerate of others in the work environment with regard to taking breaks or meal periods, use of computer and phone, noise level in the department, etc.
• Policies and Procedures
  • Knows and complies with policies and procedures as enumerated in the Orthopedic One Employee Handbook and policies and procedures documents.
  • Provides assistance and support to leadership in implementing policies and procedures as necessary.
  • Actively participates in training, and conducting day to day work activity by adhering to all policies and procedures as enumerated in compliance and risk management programs.

• Education, Experience, Certification and Licensure Requirements:
  • High School Diploma or equivalent required.
  • Previous medical billing experience, preferably in an orthopedic surgery specialty is required.
  • Candidates must have current certification as a Certified Professional Coder and additional certification specific Orthopedic Coding desirable.
  • Proficiency with software including practice management systems and Microsoft Excel.

Location:

Orthopedic One

Patient Accounts

Schedule:

Regular Full Time, Day Shift