We are seeking an experienced
Orthopedic Spine Surgery Medical Coder with a minimum of
3 years of professional medical coding experience specializing in orthopedic and spine surgery. The ideal candidate has extensive knowledge of surgical coding, clinical documentation review, and the prior authorization process. This role requires someone who can accurately interpret complex operative reports, assign compliant CPT, ICD-10-CM, and HCPCS codes, and collaborate directly with surgeons to ensure complete and accurate documentation that supports optimal reimbursement.
Success in this role requires exceptional attention to detail, strong analytical skills, and excellent communication abilities to effectively work with physicians, clinical staff, and revenue cycle teams.
Key Responsibilities
- Assign accurate CPT, ICD-10-CM, and HCPCS codes for orthopedic and spine surgical procedures while ensuring compliance with payer, CMS, and coding guidelines.
- Review and interpret complex operative reports, anesthesia records, physician documentation, and supporting clinical records to identify all billable procedures and services.
- Code a wide range of orthopedic and spine procedures, including but not limited to:
- Spinal fusions
- Decompressions
- Disc replacements
- Laminectomies
- Arthroscopic procedures
- Fracture repairs
- Joint surgeries
- Identify missing, incomplete, or insufficient documentation and proactively query surgeons or clinical staff for clarification.
- Collaborate directly with orthopedic surgeons and providers to ensure documentation accurately reflects procedures performed and supports compliant coding.
- Support the prior authorization process by verifying that assigned procedure codes align with approved authorizations.
- Identify discrepancies between authorized procedures and actual operative findings and coordinate with the Prior Authorization team to resolve coverage gaps.
- Apply appropriate surgical modifiers, including bilateral procedures, multiple procedures, assistant surgeon, co-surgeon, and other applicable modifiers.
- Review coding-related claim denials, identify root causes, and assist with appeals by providing coding expertise and supporting clinical documentation.
- Stay current with coding updates, payer policies, CMS regulations, and orthopedic/spine coding guidelines.
- Maintain productivity and accuracy standards while ensuring high-quality coding and regulatory compliance.
Qualifications
- Minimum 3 years of experience in medical coding, with significant experience in orthopedic and spine surgery coding.
- Certified Professional Coder (CPC) required; CIC, CCS, or CCS-P certification is an advantage.
- Strong knowledge of CPT, ICD-10-CM, HCPCS Level II, NCCI edits, and CMS coding guidelines.
- Extensive experience coding orthopedic and spine surgical procedures from operative reports.
- Solid understanding of surgical anatomy, orthopedic terminology, and spine procedures.
- Experience supporting or working alongside prior authorization teams for surgical cases.
- Strong knowledge of payer-specific coding requirements and modifier usage.
- Experience resolving coding denials and supporting appeals.
- Excellent written and verbal communication skills with the ability to confidently interact with surgeons and clinical staff.
- Highly organized with exceptional attention to detail and strong analytical skills.
- Proficient with electronic health records (EHR), practice management systems, and medical coding software.
- Experience coding high-volume orthopedic or spine surgery practices.
- Knowledge of commercial, Medicare, and Medicaid reimbursement guidelines.
- Familiarity with surgical revenue cycle management and reimbursement workflows.
- Experience working in a remote healthcare or medical billing environment.
Perks
- Permanent Work From Home
- Leave Credits
- Monetary Allowance
- Annual Bonus
- Weekly Paychecks
- Fixed Weekends Off
- Thriving Company Culture with Complete Autonomy
- Exclusive Specialized Training Programs
- Unlock Your Potential with a Highly Competitive Salary
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Who are we
BizForce is one of the fastest-growing global outsourcing companies in the world, founded in the US in Tucson, Arizona and is now operational in PH!
Our Commitment to delivering high-quality results for our clients and the only way to do that is ensuring a rewarding, respectful and productive experience for our employees. We hold the same values for both our customers and our employees.
