Orthopaedic Coding Analyst

2 weeks ago

Tampa, Florida, United States Orthopaedic Solutions Management Full time
Position Overview

Role Summary:

The Coding Specialist collaborates with surgeons, fellow coders, and insurance providers to ensure accurate coding practices. This position involves occasional abstract coding, addressing claim discrepancies, and engaging in denial management.

Key Duties:

  • Adhere to Orthopaedic Solutions Management policies while applying relevant federal and state coding regulations.
  • Interpret and follow up on Explanation of Benefits.
  • Conduct timely account reviews to monitor activity and ensure optimal reimbursement.
  • Maintain both the quantity and quality of assigned coding tasks.

Essential Responsibilities:

  • Identify appropriate codes and modifiers for all billable services using ICD10 CM, CPT, and HCPCS guidelines.
  • Code 100% of medical records for each assigned clinic or encounter type when available.
  • Analyze and resolve coding-related issues.
  • Abstract codes from medical documentation accurately.
  • Possess knowledge of spine coding.
  • Take necessary actions on denied claims to facilitate prompt payment.
  • Manage assigned queues and denial reports to meet performance goals.
  • Stay informed about payer guidelines and notify management of any changes.
  • Ensure accurate information is submitted to insurance companies to expedite payments.
  • Understand operative notes that dictate billed procedures.
  • Complete special assignments as required.
  • Utilize coding resources effectively to address denied procedures.
  • Document accounts accurately.
  • Comply with all company policies and procedures set forth by Orthopaedic Solutions Management.
  • Perform additional duties as assigned.

Qualifications:

  • At least five (5) years of healthcare coding experience with ICD-10-CM, PCS, CPT, and DRG classification systems.
  • A minimum of two (2) years of coding experience specifically related to spine.
  • Relevant coding certification such as CCS, CCS-P, CPC, CPC-H, CCA, COC, RHIT, RHIA, or NRCCS.
  • High school diploma or equivalent (GED).
  • Strong understanding of medical terminology and coding practices, along with experience in insurance collection and denial processes.
  • Proficient in computer skills, including Microsoft Office Suite and general EMR knowledge.
  • Experience with automated patient care and coding systems.

Preferred Skills:

  • Familiarity with ICD10, CPT, HCPCS, and the application of modifiers.
  • Experience in surgical coding.
  • Knowledge of CMS 1500 completion.
  • Prior experience with Athena.
  • Active coding certification.

About Us:

At Orthopaedic Solutions Management, we are dedicated to delivering exceptional orthopedic care. Our mission encompasses not only the clinical aspects of patient care but also the administrative processes that support our patients' experiences. We pride ourselves on fostering a culture of inclusion and providing equal opportunities for all employees.

What We Offer:

  • Full-time remote work opportunities with potential for career advancement.
  • Stable employment to promote a healthy work-life balance.
  • Join a dynamic and growing coding team.

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