Surgical Medical Coder & Billing Specialist - eCW & Waystar

Job Overview:

Are you a skilled healthcare billing professional with proven surgical coding expertise

Our client is seeking a dedicated Surgical Medical Coder & Billing Specialist to drive revenue cycle success. In this role, you will leverage hands-on proficiency with EHR platforms like eClinicalWorks (eCW) alongside major clearinghouses such as Waystar or Office Ally. Success requires deep knowledge of commercial payers, Medicare, Medi-Cal, and managed care organizations. Your strong background in denial management will directly minimize claim rejections and optimize financial results.

Schedule:

Monday - Friday, 8:30 AM - 5:00 PM PST, with 30-minute unpaid break (40 work hours per week)

Responsibilities:

Medical Coding

• Review physician operative reports and medical documentation for completeness and accuracy.
• Assign accurate ICD-10-CM, CPT, HCPCS Level II, and modifier codes.
• Code surgical procedures for:General Surgery
• Gastroenterology (GI)
• Gynecology (GYN)
• Orthopedic Surgery
• Apply Medicare, commercial payer, and ASC billing guidelines.
• Ensure compliance with NCCI edits, MUEs, LCDs, and payer-specific policies.
• Identify documentation deficiencies and communicate with providers for clarification.
• Assist with coding audits and quality assurance initiatives.

Insurance Verification & Authorizations

• Verify patient insurance eligibility and benefits.
• Obtain and manage prior authorizations and referrals.
• Review payer requirements for surgical procedures.
• Confirm coverage limitations, medical necessity, and benefit availability.
• Coordinate with physician offices and insurance carriers regarding authorization status.
• Resolve authorization issues prior to scheduled procedures.

Revenue Cycle & Billing Support

• Review claims for coding accuracy prior to submission.
• Assist billing staff with coding-related claim edits and denials.
• Research denied claims and provide coding corrections when appropriate.
• Support appeals for coding and medical necessity denials.
• Ensure documentation supports billed services.
• Maintain compliance with payer regulations and reimbursement policies.

Compliance & Quality

• Maintain HIPAA compliance and patient confidentiality.
• Stay current on CPT, ICD-10, HCPCS, CMS, Medicare, and payer updates.
• Participate in continuing education and coding training.
• Assist with internal coding audits and process improvement initiatives.

Requirements:

• Minimum of 5 years of surgical coding experience.
• Experience coding in an Ambulatory Surgery Center (ASC) preferred.
• Strong knowledge of:ICD-10-CM
• CPT
• HCPCS Level II
• Modifiers
• Medicare ASC reimbursement
• NCCI edits
• LCD/NCD guidelines
• Experience with insurance verification and prior authorizations.
• Knowledge of medical billing and claims processing.
• Ability to interpret operative reports and physician documentation.
• Excellent analytical and problem-solving skills.
• Strong written and verbal communication skills.
• Ability to work independently and manage multiple priorities.

Qualifications:

• Experience with eClinicalWorks (eCW) or similar electronic health record (EHR) systems.
• Experience using clearinghouses such as Waystar or Office Ally.
• Knowledge of commercial payer policies, Medicare, Medi-Cal, and managed care organizations.
• Experience with denial management.

Independent Contractor Perks:

• Permanent work from home
• Immediate hiring
• Health Insurance Coverage for eligible locations

Note:

Please click the Apply button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.

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