Medical Coder (Surgery & Revenue Cycle Specialist)

BruntWork

4d•Remote

About The Position

Are you a surgical coding expert with 5+ years of experience looking to drive revenue success for a premier healthcare leader? Our client is hiring a Medical Coder (Surgery & Revenue Cycle Specialist) with deep knowledge of General Surgery, GI, GYN, and Ortho coding. You will leverage your mastery of Medicare regulations, NCCI edits, prior authorizations, and payer guidelines to accurately process complex procedures and support billing operations. Proven expertise in Ambulatory Surgery Center (ASC) environments is strongly preferred to make an immediate impact on our revenue performance.

Requirements

Minimum of 5 years of surgical coding experience.
Experience coding in an Ambulatory Surgery Center (ASC) preferred.
Strong knowledge of: ICD-10-CM, CPT, HCPCS Level II, Modifiers, Medicare, ASC reimbursement, NCCI edits, LCD/NCD guidelines.
Experience with insurance verification and prior authorizations.
Knowledge of medical billing and claims processing.
Ability to interpret operative reports and physician documentation.
Excellent analytical and problem-solving skills.
Strong written and verbal communication skills.
Ability to work independently and manage multiple priorities.

Nice To Haves

Experience with eClinicalWorks (eCW) or similar electronic health record (EHR) systems.
Experience using clearinghouses such as Waystar or Office Ally.
Knowledge of commercial payer policies, Medicare, Medi-Cal, and managed care organizations.
Experience with denial management.

Responsibilities

Review physician operative reports and medical documentation for completeness and accuracy.
Assign accurate ICD-10-CM, CPT, HCPCS Level II, and modifier codes.
Code surgical procedures for: General Surgery, Gastroenterology (GI), Gynecology (GYN), Orthopedic Surgery.
Apply Medicare, commercial payer, and ASC billing guidelines.
Ensure compliance with NCCI edits, MUEs, LCDs, and payer-specific policies.
Identify documentation deficiencies and communicate with providers for clarification.
Assist with coding audits and quality assurance initiatives.
Verify patient insurance eligibility and benefits.
Obtain and manage prior authorizations and referrals.
Review payer requirements for surgical procedures.
Confirm coverage limitations, medical necessity, and benefit availability.
Coordinate with physician offices and insurance carriers regarding authorization status.
Resolve authorization issues prior to scheduled procedures.
Review claims for coding accuracy prior to submission.
Assist billing staff with coding-related claim edits and denials.
Research denied claims and provide coding corrections when appropriate.
Support appeals for coding and medical necessity denials.
Ensure documentation supports billed services.
Maintain compliance with payer regulations and reimbursement policies.
Maintain HIPAA compliance and patient confidentiality.
Stay current on CPT, ICD-10, HCPCS, CMS, Medicare, and payer updates.
Participate in continuing education and coding training.
Assist with internal coding audits and process improvement initiatives.