Certified Professional Coder III for Novant Health Physician Practices

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Job Title: Certified Professional Coder III – Orthopedic and Hand Specialty

Job Family: Medical Records

Job Function: Medical Records

Location: Mount Pleasant, SC

About Novant Health

Novant Health is a leading healthcare provider committed to delivering exceptional, patient-centered care. In our Orthopedic and Hand Specialty practices, we focus on delivering the highest level of care to those with musculoskeletal and hand-related conditions. Our team thrives on collaboration, respect, and a shared commitment to providing remarkable experiences for our patients. If you have a passion for coding in a specialized orthopedic environment and want to be part of a supportive and innovative team, we encourage you to apply!

Job Summary

We are seeking an experienced Certified Professional Coder III to join our Orthopedic and Hand Specialty team. In this role, you will be responsible for ensuring the accurate and compliant assignment of diagnostic and procedure coding for orthopedic surgeries and hand specialty treatments. You will ensure that all coding is in line with regulatory guidelines, including CMS, NCQA, and third-party payer requirements, to ensure appropriate billing and reimbursement.

In addition to coding, you will play an integral role in educating orthopedic surgeons and hand specialists on proper coding practices to maximize reimbursement and improve clinical documentation. This role requires an individual who can work independently, demonstrate attention to detail, and communicate effectively with healthcare providers and staff.

Qualifications Education

• Required: High School diploma or GED
• Preferred: Certification or additional training in medical coding, particularly in orthopedic and hand specialty coding
  
  

Experience:

• Required: Minimum of four years of healthcare experience, with at least three years of professional coding experience, preferably in orthopedic and hand specialties
• Preferred: Two years of medical terminology experience and three years of customer service experience in a clinic setting
  
  

Licensure/Certification:

• Required: CPC, CCS-P, COC, RHIA, CMC, or RHIT certification
  
  

Skills & Requirements:

• Proficiency in CPT, ICD-9, ICD-10, and HCPCS coding systems with a focus on orthopedic and hand specialty procedures
• Experience with EPIC Resolute Billing preferred
• Strong communication skills, both written and verbal
• Ability to work independently, perform self-audits, and resolve coding discrepancies
• Ability to engage with orthopedic physicians and hand specialists to provide feedback and education on correct coding practices
• Expertise in applying, interpreting, and training others on coding classifications systems and documentation guidelines specific to orthopedic and hand specialties
• Familiarity with coding audits, denials, and front-end education
  
  

Key Responsibilities Coding & Documentation:

• Review and code orthopedic and hand surgery procedures with minimal supervision, ensuring adherence to ICD-10, CPT, and HCPCS coding guidelines
• Query providers for clarification on incomplete or ambiguous documentation and ensure timely follow-up to resolve issues
• Provide continuous education and feedback to orthopedic surgeons and hand specialists on proper documentation and coding practices
  
  

Process Management:

• Stay updated on coding, compliance, and reimbursement procedures specific to orthopedic and hand specialties through review of payer policy updates, coding manuals, and RCS guidelines
• Respond to coding-related inquiries from billing, collections, and administrative staff, ensuring accurate coding and reimbursement
• Assist physicians in interpreting complex coding and documentation guidelines, ensuring correct billing for orthopedic and hand procedures
  
  

Error Auditing & Education:

• Shift from a back-end coding process to a front-end educational approach by monitoring coding errors, edits, and denials specific to orthopedic and hand specialties
• Provide on-site education to clinicians, helping them understand common coding issues related to orthopedic and hand procedures and offering solutions to improve documentation
• Offer regular reporting and analysis regarding coding efforts, missed opportunities, and discrepancies, while suggesting solutions for improvement
• Collaborate with orthopedic physicians and hand specialists to streamline coding fields in EMR systems, ensuring accuracy and eliminating errors
  
  

Why Join Novant Health?

At Novant Health, we are committed to providing a collaborative, respectful, and innovative work environment. As a part of our Orthopedic and Hand Specialty team, you’ll have the opportunity to work with dedicated professionals in a fast-paced, rewarding setting. We value your expertise, offer opportunities for professional development, and empower you to make a difference in our patients' lives. If you're looking for a fulfilling career where your skills will have a meaningful impact, join us today!

Novant Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

Novant Health is an equal opportunity employer and conducts all human resource practices in compliance with federal, state and local civil rights and employment legislation. Accordingly, Novant Health considers all applicants for employment equally, without regard to race, color, religion, sex, national origin, age, disability, veteran’s status, marital status, sexual orientation, gender identity or expression and provides them with an opportunity to progress in the organization consistent with their skills and interests.

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