Medical Coding Specialist- Hybrid/Remote

ORTHOPAEDIC ASSOCIATES OF WISCONSIN • Village of Pewaukee, WI

1d • Hybrid

About The Position

Individuals will be responsible for coding all physician, clinical, and surgical claims. Review documentation via EHR or operative note to verify the accuracy and completeness of CPT and ICD10 code assignment for claims submission. The Medical Coder is responsible for translating medical documentation into standardized codes that accurately represent the patient's medical history, treatments, and procedures. The role ensures that the hospital’s billing processes are precise and compliant with regulations, facilitating efficient reimbursement from insurance companies and payers.

Requirements

• High School Diploma or equivalent
• Minimally 3 years of coding experience, preferably in orthopedics
• Certification from either the American Academy of Professional Coders (CPC) or the American Health Information Management Association (AAPC)
• Advanced knowledge of ICD, CPT, and HCPCS coding guidelines
• Advanced knowledge of medical terminology, anatomy and physiology, and regulatory requirements
• Ability to develop rapport and maintain positive, professional relationships with physicians
• Excellent critical thinking and analytical skills, with a high attention to detail
• Ability to work independently and exercise independent judgment and decision-making
• Ability to meet deadlines while working in a fast-paced environment
• Strong computer skills including knowledge of Microsoft Office

Nice To Haves

• EPIC experience preferred

Responsibilities

• Serves as the key point of contact for coding information
• Provides onsite coding and documentation, education, and feedback to providers for coding changes (CPT including E&M, modifiers and internal codes, ICD-9, ICD-10, HCPCS), annual updates, payor requirements, and insurance rejection resolution
• Staying abreast of payer regulations and documentation requirements. Stay updated with coding guidelines, payer policies, and regulatory changes.
• Procedure precertification assigning of ICD-10 and CPT codes.
• Maintains current knowledge of Medicare, Medicaid, and other regulatory requirements of nationally accepted coding policies and standards. Ensure coding practices adhere to legal and ethical standards, including HIPAA regulations.
• Coding in-office E&M services, procedures, and surgeries. Assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and services.
• Review and analyze patient medical records and documentation from physicians.
• Ensure accuracy and completeness of coded data for statistical and reimbursement purposes.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED