Certified Professional Coder- Orthopedic

Certified Professional Coder- Orthopedic Job Summary: The Certified Professional Coder performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system. (This is a full-time hybrid or remote position that will support the RCM team, Monday to Friday 8 am to 5 pm- Coding certification required) Primary Job Responsibilities/Tasks may include, but not limited to: - Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers. - Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA. - Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process. - Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met. - Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding. - Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients. - Reviews all physician documentation to ensure compliance with third party and regulatory guidelines. - Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services. - Performs other related duties as required and assigned. Requirements: Education and Certifications: - High school diploma or GED completion is required. - A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required. - Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure. - Advanced working knowledge of medical terminology, anatomy, and physiology required. - Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers. - Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Experience: - Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred. - Knowledge of current third-party billing and collection regulatory guidelines and requirements. - Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions. - Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies. - Knowledge of current third-party billing and collection regulatory guidelines and requirements. - Good interpersonal skills and a basic understanding of team concept. - Ability to gather and interpret clinical data. - Ability to work independently in a fast-paced environment. Physical Requirements: - Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling. - Must be able to lift and support weight of 35 pounds. - Ability to concentrate on details. - Use of computer for long periods of time. Originally posted on Himalayas