Certified Coder/Surgical Case Reviewer (F/T) - Remote

Optim • Savannah, GA

103d

About The Position

Optim Health System is seeking (2) full time Certified Coder/Surgical Case Reviewer(s). This is a remote position. The Surgical Case Reviewer will report directly to the Patient Access Director and will not have any supervisory responsibilities. The typical working conditions are remote, allowing for flexibility in the work environment.

Requirements

• Certified Professional Coder certification
• Three or more years of experience in focus fields (Orthopedic, Neuro Spine, Ortho Spine, Sports Medicine, Pain Management)

Responsibilities

• Review all surgical orders submitted for all Optim facilities, focusing on Orthopedic, Neuro Spine, Ortho Spine, Sports Medicine, and Pain Management.
• Review orders for appropriate documentation and coding; provide feedback to physicians on any discrepancies.
• Conduct Medical Necessity reviews according to payer guidelines.
• Communicate and educate Surgeons and Surgical teams.
• Work with multi-disciplinary teams to ensure codes on order and precertification are accurate and complete.
• Stay current on all relevant coding guidelines as well as payer requirements.
• Meet or exceed industry standard production levels and maintain 95% accuracy in quality assurance reviews.
• Experience with electronic health records.
• Assist Clinical Revenue with Medical Necessity denials.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees