Surgical Coding Specialist

On-siteHealthcareFull-time

Full-time, Monday–Friday, 8:30 AM–5:00 PM.

Reviews operative reports and assigns and sequences accurate CPT codes, modifiers, and ICD-10 codes to surgical procedures.
Enters CPT, modifiers, and ICD-10 codes into the practice management software for claim submission.
Reviews and analyzes data when insurance denies payment of surgical procedures; ensures proper codes were submitted and files appeal letters if needed to receive proper reimbursement.
Responsible for tracking appeals.
Maintains current knowledge of relevant coding changes as they become effective and assists in implementing them.
Answers questions from patients, clinical, and billing staff.
Maintains patient confidentiality and follows HIPAA guidelines.
Assists prior-authorization team with needed CPT codes for upcoming surgical cases to obtain authorization.
Assists patients with surgical estimates.
Performs other duties as assigned.

High School Diploma or GED.
One year of experience with CPT and ICD-10 coding in a healthcare organization preferred.
Certified Professional Coder (CPC) required.

Knowledge of medical terminology, abbreviations, techniques, and procedures; anatomy and physiology.
Knowledge and understanding of official coding rules established by the American Medical Association (AMA) and the Center for Medicare and Medicaid Services (CMS) for assignment of procedural codes.
Proficiency in both CPT and ICD-10 coding.
Knowledge of billing practices and clinic policies and procedures.
Ability to effectively examine documents for accuracy and completeness.
Ability to research and resolve a wide variety of problems.
Ability to work independently and meet deadlines.
Clear verbal and written communication with clinical and non-clinical staff as well as the public.

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