The Certified Coding Specialist is responsible for accurate and compliant coding of complex orthopedic procedures across all care settings. This role supports revenue integrity by ensuring appropriate CPT and ICD-10 coding, reducing denials, and improving provider documentation quality.
Key responsibilities include complex surgical coding for orthopedic and neurosurgical procedures, denial prevention and root cause analysis, pre-bill quality review, provider documentation improvement, vendor oversight, appeals support, and enforcement of coding standards and guidelines.
Requirements & Qualifications
Required Qualifications
- CPC, CCS, or equivalent certification (AAPC or AHIMA)
- 5+ years of surgical coding experience
- Deep knowledge of NCCI edits and bundling rules
- Strong understanding of modifier usage, including 22, 25, 50, 51, 57, 59, 62, and 76
- Knowledge of orthopedic and spine-specific CPT coding nuances
- Understanding of documentation requirements for Evaluation and Management services
- Experience with orthopedic or multi-specialty groups preferred
- Excellent organization and multitasking skills
- Detail-oriented and able to work in a fast-paced, results-driven environment
Preferred Qualifications
- COSC specialty certification (AAPC)
- Experience in a high-volume orthopedic or spine practice
- Exposure to vendor-managed RCM environments
- Familiarity with ModMed or athenahealth
Benefits & Perks
Benefits and Perks
- Competitive compensation
- Generous PTO
- Health, dental, and vision insurance
- 401(k)
- Excellent growth and advancement opportunities
- Dynamic work environment
- Access to a diverse network of practitioners
- Broad infrastructure of tools and programs to enhance the employee experience
Location
Connecticut, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
2 weeks ago