Coder

EXCELSIOR ORTHOPAEDICS GROUP•Eggertsville, NY

13d•$20 - $28•Onsite

About The Position

The Coder reviews, interprets, and assigns appropriate CPT, ICD-10, and HCPCS codes while ensuring compliance with federal and state regulations, payer policies, and company requirements. The role reviews operative reports for procedures performed by Excelsior Orthopaedic Physicians for completeness and abstracts and codes clinical data using standard classification systems. It also supports charge entry, claim preparation and submission, and resolution of coding and reimbursement issues. The Coder works with providers, clinical staff, and the billing team to support accurate documentation, coding, and reimbursement. The position requires staying current with coding guidelines and payer updates, and may include additional job-related duties as assigned.

Requirements

High school diploma or GED required.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification required.
At least 1 year of experience as a coder or in a similar role required.
Ability to work independently and collaboratively in a fast-paced, team-oriented environment.
Computer proficiency in Microsoft Word, Excel, Outlook, and Teams required.

Nice To Haves

Associate degree preferred.
Experience with an electronic health record (EHR/EMR) and coding software preferred.
Knowledge of orthopedic, physical therapy, or podiatry medical terminology desirable.

Responsibilities

Demonstrate the organization’s core values of being patient centered, team focused, service driven, accountable, and innovative.
Review and audit physician documentation and surgical reports and assign diagnosis and procedure codes for orthopedic services, including office visits, imaging, physical therapy, and surgical procedures.
Ensure coding practices meet federal and state guidelines, payer-specific requirements, and company policies.
Communicate with providers and clinical staff to support accurate documentation and coding.
Monitor coding edits, denials, and rejections, and assist with appeals and corrections as needed.
Collaborate with the billing team to resolve coding and reimbursement issues.
Stay current with coding guidelines, orthopedic-specific regulations, and payer updates.
Enter and itemize charge data in the billing system, ensuring completeness and adherence to internal policies.
Verify and apply CPT, ICD-10, and HCPCS codes based on provider documentation, escalating complex coding issues to certified coders when needed.
Prepare, process, and transmit electronic and paper insurance claims in accordance with payer requirements and deadlines.
Collect and verify information needed to complete billing, including patient demographics, insurance coverage, and provider charge details.
Perform supplemental responsibilities and other job-related duties as assigned.