Orthopedic Coding Specialist

Responsible for orthopedic coding and compliance for assigned Orthopedic One providers.

Orthopedic Coding

• Review operative notes to code for providers who have A/R support provided by staff not credentialed as CPC.
• Review NCCI edits to code modifiers for surgeries based on operative reports.
• May code hospital consults for assigned physicians.
• Review incomplete charge slips identified by other staff members for missing procedures or coding issues and provide team members with information needed to complete charge entry.

Shares Knowledge / Educates

• Assist the director in educating billable providers on proper use of modifiers and other remedial coding instruction.
• Review various billing sources for orthopedic-specific updates and communicate information to the Patient Accounts Department regarding insurance guideline changes or precertification requirements.
• Serve as a resource to management when needed for orthopedic-specific coding.
• Provide updates to Patient Accounts staff and the organization regarding changes in precertification requirements by carrier, as assigned.

Customer Service and Communications

• Communicate with patients, insurance carriers, and other outside entities in a professional manner.
• Respond professionally to patient concerns and use appropriate grammar, tact, and diplomacy in interactions by phone and in person.
• Diffuse negative situations with patients and maintain a pleasant, professional tone during stressful circumstances and heavy workload.
• Communicate with staff members in a professional and constructive manner.

Teamwork

• Provide coverage, volunteer assistance, and maintain department workflows as needed without direct instruction or supervision.
• Work cooperatively and avoid negative conversations.
• Share knowledge and insights with co-workers in a constructive manner.
• Solve problems and address conflicts directly with the appropriate person before involving leadership or uninvolved peers.
• Be considerate of others in the work environment, including break times, computer and phone use, and noise level.

Policies and Procedures

• Comply with policies and procedures in the Orthopedic One Employee Handbook and related policy documents.
• Assist leadership in implementing policies and procedures as necessary.
• Participate in training and daily work activities while adhering to compliance and risk management programs.

Work Arrangement

• Candidates must live in Ohio permanently.
• Remote work arrangement is available after completion of an onboarding period, generally 10 to 14 days.