Surgical Coder - Spine Specialty

Spire Orthopedic Partners•Stamford, CT

2d•Onsite

About The Position

Spire Orthopedic Partners is a growing national partnership of orthopedic practices that provides the support, capital and operational resources physicians need to grow thriving practices for the future. As a Management Services Organization (MSO), Spire provides the infrastructure for administrative operations that allows practices to operate at their highest level, so doctors can focus their efforts on what matters most – patient care. Headquartered in Stamford, Connecticut, the Spire network spans the Northeast with more than 165 physicians, 1,800 employees, 285 other clinical providers and 40 locations in New York, Connecticut, Rhode Island and Massachusetts. What you’ll do: The Surgical Coder for Spine is responsible for accurate and compliant coding of complex orthopedic spine procedures across all care settings. This role directly impacts revenue integrity by ensuring optimal CPT/ICD-10 coding, minimizing denials, and supporting provider’s documentation improvement.

Requirements

CPC, CCS, or equivalent certification (AAPC or AHIMA)
5+ years of surgical coding experience
3+ years focused on spine surgery coding
Deep knowledge of: NCCI edits and bundling rules
Modifier usage (e.g., 22, 25, 50, 51, 57, 59, 62, 76)
Spine-specific CPT coding nuances
Documentation requirements for Evaluation and Management services
Excellent organization skills
Detailed oriented and comfortable with multi-tasking
Ability to work in face-paced, results driven position
Administer and uphold all the Company’s values and policies and procedures.
Continuously work towards the Company’s goal and vision.
Performs other duties as assigned.

Nice To Haves

Experience with orthopedic or multi-specialty groups preferred
COSC specialty certification (AAPC)
Experience working in a high-volume orthopedic/spine practice
Exposure to vendor-managed RCM environments
Familiarity with systems like ModMed or athenahealth

Responsibilities

Code high-complexity spine procedures (e.g., fusions, decompressions, instrumentation, revisions)
Verifying all documentation is complete and compliant
Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines.
Follows coding conventions and ensure accurate assignment of: CPT (including add-on codes, modifiers, bundling rules) ICD-10 diagnoses supporting medical necessity
Validate: Levels, laterality, approach (anterior/posterior) Instrumentation and graft usage
Identify missed billable components (e.g., additional levels, hardware, biologics)
Query provider for any necessary clarification related to unclear, unspecified or missing/incomplete documentation
Apply payer-specific coding rules and edits
Researches, analyzes, recommends, and facilitates a plan of action to correct discrepancies and prevent future coding errors:
Review coding-related denials (medical necessity, bundling, documentation)
Perform root cause analysis and trend identification
Partner with RCM and vendor teams to implement corrective actions
Develop coding edits and pre-bill review processes for high-risk procedures
Perform targeted pre-bill audits for: High-dollar spine surgeries Multi-level and complex cases
Ensure documentation supports: Medical necessity Procedure specificity
Escalate documentation gaps prior to claim submission
Partner with surgeons to improve documentation quality
Provide targeted, case-based feedback: Missing elements impacting coding accuracy Opportunities to fully capture procedure complexity
Support education on: Modifier usage Documentation specificity (levels, implants, approach)
Audit external coding vendor performance (if applicable)
Identify discrepancies between internal and vendor coding
Provide feedback and enforce coding standards
Support development of SOPs and coding guidelines
Serves as primary resource and Spire Point of Contact (SPOC) between provider and vendor
Provide clinical/coding rationale and documentation validation
Partner with AR teams on high-value accounts