Orthopedic and Plastic Surgery Medical Coding Specialist

Summary

Join our team as a part-time Orthopedic and Plastic Surgery Medical Coder! This role requires a highly skilled and detail-oriented Certified Medical Coder with ambulatory surgery coding experience. You will accurately code orthopedic and plastic surgery procedures using CPT, ICD-10-CM, and HCPCS coding systems. Compliance with federal regulations and payer guidelines is crucial. Collaboration with physicians and billing teams is essential for accurate charge capture. Continuous skill enhancement through staying updated on coding guidelines is expected. Maintain patient confidentiality and conduct periodic audits to ensure accuracy. This home-based position requires a minimum of three years of coding experience, including at least two years in ambulatory surgical coding, specifically in orthopedic and plastic surgery.

Requirements

• High school diploma or GED equivalent
• Completion of a formal coding program with the following certification required: Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), or equivalent AAPC or AHIMA approved coding credential
• Candidates with apprenticeship designations in their credentials, regardless of years of experience, will not be considered
• Minimum of three years’ coding work experience encompassing a working knowledge of the ICD and CPT coding systems; medical terminology; anatomy and physiology; and health record content
• At least 2 years' specifically in ambulatory surgical coding with a strong focus on Orthopedic and Plastic Surgery procedures
• Exhibits a sense of urgency towards work, possesses intermediate level computer skills, attention to detail, excellent customer service and written and verbal communication skills

Responsibilities

• Accurately review and assign CPT, ICD-10-CM, and HCPCS Level II codes to orthopedic and plastic surgery procedures performed in an ambulatory surgery setting
• Ensure that coding is compliant with federal regulations, payer-specific guidelines, and facility coding policies. Meets productivity standards for position
• Abstract relevant clinical information from surgical notes, operative reports, and related medical documentation
• Work collaboratively with physicians, surgical staff, and billing teams to clarify documentation and ensure coding accuracy
• Utilize coding software, encoder tools, and EHR systems effectively to support accurate and timely charge capture
• Continually enhances coding skills by keeping up-to-date with current coding guidelines and changes in regulations, payer policies, and CMS requirements. Participates in team meetings and educational conferences to ensure coding practice remains current
• Maintains confidentiality and safeguards the privacy of protected health information (PHI)
• Conduct periodic audits of coded data to ensure accuracy and identify areas for improvement
• Assist in resolving coding-related denials and contribute to appeal processes when necessary
• Performs other job related duties as may be assigned or required

Preferred Qualifications

• Preferred experience to those with familiarity with NCCI edits, modifier usage, and payer-specific rules
• Knowledge of reimbursement methodologies (e.g., APC's, fee-for-services)