Description
About the Role
We are seeking an experienced Orthopedic Medical Coder with current, hands-on orthopedic coding expertise to support a dynamic healthcare organization. The ideal candidate is actively coding orthopedic services on a regular basis and remains current on orthopedic coding guidelines, payer requirements, and regulatory updates.
This position is ideal for a coding professional who enjoys working collaboratively with providers while ensuring coding accuracy, compliance, and optimal reimbursement. In addition to coding responsibilities, this role includes providing coding guidance, documentation feedback, and education to physicians and clinical staff.
Flexible schedules are available with opportunities to work 20 plus per week.
Key Responsibilities
Charge Review Work Queues
- Review provider-submitted coding in Epic against clinical documentation.
- Resolve coding edits and recommend appropriate coding corrections.
- Ensure accurate CPT, ICD-10-CM, and modifier assignment.
Claim Edit Work Queues
- Review provider-submitted coding to resolve clearinghouse rejections and claim edits.
- Recommend coding corrections based on documentation and payer guidelines.
Follow-Up Work Queues
- Review post-bill denials and payer edits.
- Analyze documentation and recommend coding updates to support claim resolution.
Additional Responsibilities
- Review clinical documentation for coding accuracy and compliance.
- Resolve billing edits, coding edits, denials, and payer-specific requirements.
- Provide coding education, documentation feedback, and best practice recommendations to orthopedic providers and clinical departments.
- Maintain compliance with federal regulations, payer policies, and industry coding standards.
Requirements
Required Qualifications
- Minimum 3 years of current, hands-on orthopedic coding experience.
- Current CPC, CCS, RHIT, RHIA, or other equivalent coding credential through AAPC or AHIMA.
- Extensive experience coding orthopedic services in POS 11 (Office), POS 21 (Inpatient Hospital), and POS 22 (Outpatient Hospital).
- Experience coding orthopedic office procedures and surgical services.
- Strong knowledge of CPT, ICD-10-CM, HCPCS, NCCI edits, modifier usage, bundling and unbundling guidelines, and payer-specific requirements.
- Experience resolving billing edits, clearinghouse edits, denials, and payer rejections.
- Strong communication skills with the ability to provide coding feedback and education to providers.
Preferred Qualifications
- Multi-specialty coding experience in three or more additional specialties outside of orthopedics (such as pain management, neurosurgery, sports medicine, physical medicine & rehabilitation, general surgery, or other surgical specialties).
- Experience using Epic.
- Knowledge of California Medicaid (Medi-Cal) coding and billing guidelines.
- Experience supporting provider documentation improvement initiatives.
Orthopedic Coding Expertise
Candidates should have strong experience coding a broad range of orthopedic services, including:
- Spine injections and pain management procedures
- Open and closed fracture care
- Hand surgery
- Tendon repairs
- Carpal tunnel release
- Hardware removal
- Neuroplasty
- Shoulder, knee, and hip arthroscopy
- Shoulder, knee, and hip arthroplasty
- Joint repairs and reconstruction
- Orthopedic trauma procedures
Why Join Us
- 100% Remote Opportunity
- Flexible part-time schedules (10-30 hours per week)
- Collaborative, highly specialized coding team
- Comprehensive benefits for eligible full-time employees
- Complimentary CEU opportunities
- Company-provided equipment
Apply Today
If you are an experienced orthopedic coder who is actively coding orthopedic services and is looking for a flexible remote opportunity with a collaborative team, we encourage you to apply. Candidates with additional multi-specialty coding experience are especially encouraged to apply.