Job Summary

The Medical Coder is responsible for accurately coding orthopedic related services. The Coder effectively reviews, post data, and corrects all claims to aid in providing outstanding patient care.

Major Responsibilities/Activities

· Maintain current knowledge of CPT, HCPCS and ICD coding systems, including the appropriate application of procedure code modifiers and NCCI edits.

· Maintain current knowledge of Medicare, Medicaid and all other third-party payer regulatory and compliance guidelines with regard to coding and claim submission for professional medical services.

· Gathering and organizing all necessary data from physicians, hospitals and other personnel to ensure accurate and timely submission of claims submitted to third-party payers.

· Verify codes submitted to third party payers are an accurate representation of medical service rendered by the provider. Research any discrepancies noted prior to charge entry to ensure accuracy.

· Evaluates medical record documentation and charge tickets to ensure completeness, accuracy and compliance.

· Reviews and works all denials for coding to completion.

· Medical Coding of Orthopedic professional and surgical procedures.

· Provides other related duties as required and assigned.

Education and Qualifications

High School Diploma

Maintains current Certified Coding Specialist or Certified Professional Coder

Advanced knowledge of ICD-9, ICD-10, Medical Terminology and medically approved abbreviations

Thorough understanding of CMS coding and billing guidelines

Attention to detail and ability to achieve a high level of accuracy

Expected Hours of Work

This is a full time position. Typical hours of work are Monday through Friday from 8:00 am to 5:00 pm.

Equipment Used

This job operates in a professional medical clinic environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, fax machines.

Physical Demands

The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This is primarily a seated position. The employee is occasionally required to stand, walk, and reach with hands and arms. The employee may occasionally lift 5-20 pounds.

Travel

Minimal travel may be required.