Medical Coder

EXCELSIOR ORTHOPAEDICS GROUP•Eggertsville, NY

1d•Onsite

About The Position

The Coder is responsible for reviewing, interpreting, and assigning appropriate CPT, ICD-10, and HCPCS codes, and ensuring compliance with federal regulations and payer policies. This position is responsible for reviewing operative reports for all procedures performed by Excelsior Orthopaedic Physicians for completeness and to abstract and code clinical data, using standard classification systems. The role also involves demonstrating core values of being patient centered, team focused, service driven, accountable, and innovative every day.

Requirements

HS diploma or GED required.
Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification is required.
Proven experience (1+ years) as a Coder or in a similar role required.
Ability to work independently and collaboratively in a fast-paced, team-oriented environment.
Computer skills required with minimum proficiency in Microsoft Word, Excel, Outlook, and Teams.

Nice To Haves

Associates degree preferred
Demonstrated ability and understanding of an electronic health record (EHR/EMR) and coding software is preferred.
Knowledge of orthopedic, physical therapy, or podiatry medical terminology is desirable.

Responsibilities

Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day.
Review and audit physician documentation and surgical reports to accurately assign diagnosis and procedure codes for orthopedic services, including office visits, imaging, physical therapy, and surgical procedures.
Ensuring coding practice meets federal and state guidelines, payer-specific requirements, and company policies.
Communicate with providers and clinical staff to ensure accurate documentation to produce accurate coding.
Monitor coding edits, denials, and rejections; assist in 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.
Accurately enter and itemize charge data into the billing system, ensuring completeness and adherence to internal policies.
Assist with verifying and applying correct CPT, ICD-10, and HCPCS codes based on provider documentation; escalate complex coding issues to certified coders when needed.
Prepare, process, and transmit insurance claims (electronic and paper) in accordance with payer requirements and deadlines.
Collect and verify all the information necessary to complete the billing process, including patient demographics, insurance coverage, and provider charge details.
Evolve in your role when performing supplemental responsibilities as assigned.