Coder - Professional (Orthopedic)- Multiple

Job Description

Job Requisition: Orthopedic Coding Specialist
Job Title
Orthopedic Coding Specialist (Professional Fee)
Department
Coding Operations
Position Summary
The Orthopedic Coding Specialist is responsible for accurately reviewing, assigning, and validating diagnosis and procedure codes for orthopedic services. This position ensures compliance with ICD-10-CM, CPT, HCPCS Level II, and payer-specific guidelines while supporting accurate reimbursement, regulatory compliance, and quality reporting initiatives. The coder will work closely with providers, auditors, clinical staff, and revenue cycle teams to ensure complete and compliant documentation.
Key Responsibilities
Review and assign ICD-10-CM, CPT, and HCPCS codes for orthopedic surgical and non-surgical encounters.
Code complex orthopedic procedures including: Joint replacement and revision surgeries
Arthroscopy procedures
Fracture care and trauma cases
Spine procedures
Sports medicine procedures
Hand and upper extremity surgeries
Foot and ankle procedures

Apply National Correct Coding Initiative (NCCI) edits and payer-specific guidelines.
Review operative reports, clinic notes, and ancillary documentation for coding accuracy.
Query providers when documentation clarification is required.
Monitor coding edits, denials, and reimbursement trends.
Participate in coding audits and quality improvement initiatives.
Assist with education related to coding changes and documentation requirements.
Maintain productivity and quality standards as established by the organization.
Required Qualifications
High School Diploma or GED required.
Minimum of 5-6 years of orthopedic coding experience .
Strong knowledge of: ICD-10-CM
CPT
HCPCS Level II
CMS guidelines
NCCI edits
Orthopedic anatomy and physiology

Experience coding operative reports and orthopedic surgeries.
Proficiency with EHR and encoder software.
Preferred Qualifications
Associate's or Bachelor's degree in Health Information Management, Healthcare Administration, or related field.
Experience with academic medical centers or large multi-specialty physician practices.
Familiarity with risk adjustment and quality reporting programs.
Previous auditing or education experience.
Required Certifications
One or more of the following:
Certified Professional Coder (CPC)
Certified Coding Specialist (CCS)
Knowledge, Skills, and Abilities
Extensive knowledge of orthopedic procedures and terminology.
Strong analytical and problem-solving skills.
Excellent attention to detail.
Ability to work independently and manage competing priorities.
Strong written and verbal communication skills.
Proficient in Microsoft Office applications.
Performance Metrics
Coding accuracy ≥ 95%
Productivity standards met or exceeded
Timely completion of assigned work queues
Compliance with regulatory and payer requirements
Reduction in coding-related denials