The Certified Medical Coder – Orthopedics is responsible for accurately reviewing and coding medical records for orthopedic services, including office visits, procedures, and injections. This role ensures proper documentation, coding compliance, and optimal reimbursement while supporting providers in a fast-paced specialty practice. They also follow up on denied claims.

The key responsibilities include reviewing orthopedic medical records, operative reports, and provider documentation for completeness and accuracy; assigning appropriate diagnosis and procedure codes using ICD-10, CPT, and HCPCS; accurately coding services such as fracture care, joint injections, casting/splinting, and surgical procedures; ensuring proper use of modifiers (e.g., -25, -50, -59, RT/LT) specific to orthopedic billing; verifying documentation supports medical necessity and coding selections; querying providers when clarification is needed; maintaining compliance with payer guidelines including Medicare, commercial plans, and VA requirements; staying current with coding updates, orthopedic guidelines, and regulatory changes; and following up on denied claims.

Qualifications required:

Certified Professional Coder (CPC) through AAPC or Certified Coding Specialist (CCS) through AHIMA
Minimum of 1–2 years of medical coding experience; orthopedic coding experience preferred
Strong understanding of musculoskeletal anatomy and orthopedic terminology
Familiarity with Epic electronic health records

Skills include high attention to detail and accuracy, strong knowledge of orthopedic procedures and coding nuances, effective communication skills for provider queries and team collaboration, and strong organizational and time management skills.

Work environment is an orthopedic specialty practice in a fast-paced setting with a high volume of procedures and encounters.

Certified Professional Coder