Certified Coder-Orthopaedics

Performs functions such as reviewing documentation and selecting the appropriate procedure and / or diagnosis code to be entered in billing documents. Ensures that teaching physician requirements are met and are clearly reflected in the documentation; and other duties as assigned.

ESSENTIAL FUNCTIONS

• Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines.
• Ensures that teaching physician documentation and billing requirements are met and are clearly reflected.
• Review provider coding and provide training and feedback on coding questions and issues.
• Assists billing and collections staff with denials and charge correction requests as needed.
• Resolves coding TES edits.
• Continually refreshes and applies knowledge of government regulations as they relate to coding and billing.

EDUCATION and/or EXPERIENCE
* High school diploma or general education degree (GED) preferred
* Certified Professional Coder certification required
* Orthopedic experience preferred, but not required
* Extensive knowledge of CPT and ICD-10 coding
* Knowledge of government regulations as they relate to teaching physician

documentation and billing guidelines

* Understanding of: the importance of compliance with all government, department, and contractual regulations regarding coding and billing; and provider requirements