Certified Billing and Coding Specialist with Orthopedic Experience

Job Title: Certified Coder/Biller with Orthopedic Experience

Location: GTSC Management - Beaumont
Department: Billing

Job Overview:

We are seeking an experienced, detail-oriented Certified Coder/Biller with specialized knowledge in orthopedic coding and billing to join our team. This role is critical in ensuring accurate coding of medical services, compliant billing practices, and efficient revenue cycle management. The ideal candidate will have expertise in ICD-10, CPT, HCPCS, and modifiers specific to orthopedic procedures.

Key Responsibilities:

• Accurately code medical diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes, ensuring that orthopedic services are correctly represented.
• Prepare and submit claims to insurance companies, government payers (Medicare/Medicaid), and third-party payers for reimbursement of orthopedic services provided.
• Review medical records, physician notes, and other documentation to ensure proper code assignment.
• Maintain compliance with all coding, billing, and regulatory requirements for orthopedic services, including understanding the latest coding guidelines and payer policies.
• Follow up on unpaid or denied claims, working with insurance companies to resolve discrepancies and obtain payment.
• Work closely with physicians and office staff to clarify documentation and ensure accurate coding.
• Verify patient insurance information and pre-certify services when necessary.
• Maintain knowledge of current trends, payer policies, and orthopedic coding practices.
• Assist in auditing, reporting, and resolving issues related to coding and billing.
• Monitor and meet established coding productivity standards and deadlines.
• Provide training and education to clinical staff on accurate documentation practices to ensure optimal coding.

Qualifications:

• Certification: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification required.
• Experience: Minimum of 3 years of coding and billing experience in an orthopedic setting.
• Knowledge: Strong knowledge of orthopedic anatomy, procedures, and terminology. Familiarity with orthopedic surgery coding, joint replacement, fracture management, and musculoskeletal conditions is essential.
• Technical Skills: Proficiency in coding software and electronic health record (EHR) systems, such as Epic, Cerner, or similar.
• Attention to Detail: Strong attention to detail, ensuring accuracy in coding, billing, and compliance.
• Communication Skills: Excellent verbal and written communication skills for interacting with physicians, insurance companies, and patients.
• Problem-Solving: Ability to research and resolve coding and billing discrepancies efficiently.
• Education: High school diploma or equivalent required

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Preferred Qualifications:

• Experience with ICD-10 coding updates and orthopedic procedural coding.
• Prior experience with payer audits and appeals in the orthopedic field.
• Knowledge of Medicare/Medicaid and commercial insurance guidelines for orthopedic services.
• Experience in a fast-paced environment with high volume billing and coding.

Work Environment:
This position is typically performed in an office setting, with occasional interaction with patients and clinical staff. Telecommuting may be an option depending on office policies.

Physical Demands:

• Prolonged periods of sitting at a desk and working on a computer.
• Occasional lifting of office supplies or files up to 10 pounds.

Salary:
Competitive salary based on experience, with benefits package including benefits like health insurance, retirement plans, paid time off, etc.

This job description provides an overview of the responsibilities and qualifications required for a Certified Coder/Biller with orthopedic experience. Duties and expectations may evolve as needed by the organization.

Job Type: Full-time

Pay: $18.00 - $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Work Location: In person

Salary : $18 - $22