Job Description
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
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