Senior Coding Operations Specialist

Job Description

Job Description

ESSENTIAL FUNCTIONS
• Monitor coding backlogs, turnaround times, unresolved encounters, missing documentation, and workflow exceptions.
• Reconcile coding work queues, surgery schedules, missing slips, EFS/charge capture systems, and other applicable
workflows.
• Serve as a senior coding resource for complex procedural, surgical, specialty, and payer-related coding questions.
• Research and apply CPT, ICD-10-CM, HCPCS, NCCI, payer policies, and regulatory guidance.
• Identify coding trends, workflow concerns, documentation issues, and areas of risk and provide recommendations to
Coding leadership/CDI.
• Support audit trend analysis, root-cause review, and development of corrective education.
• Assist the Coding Manager and Supervisors with special projects, workflow reviews, market needs, and process
improvement initiatives.
• Escalate staffing or employee workflow and performance concerns to Coding leadership.
• Provide production coding support as needed based on departmental priorities.

EDUCATION
• High School Diploma/GED

EXPERIENCE

• 5+ years of professional medical coding experience, preferably with orthopedic surgical coding. Must be AAPC/AHIMA certified with maintained credentials

REQUIREMENTS
• Coding Certification from AAPC/AHIMA (CPC, CCS-P, COSC)

KNOWLEDGE
• Knowledge of medical terminology
• Strong experience reviewing operative reports and complex clinical documentation.
• Advanced knowledge of CPT, ICD-10-CM, HCPCS, modifiers, NCCI edits, and payer guidelines.
• Experience with coding audits, reconciliation, workflow analysis, or coding education preferred. 

Strong analytical, research, organizational, and communication skills.
• Ability to work independently, manage multiple priorities, and serve as a senior coding subject-matter expert.
• The ability to identify and resolve discrepancies in medical records or claims.
• Accuracy is critical in coding, requiring meticulous attention to detail.
• The ability to communicate effectively with physicians and other healthcare professionals.
• Efficiently inputting and managing coding data.

ABILITIES
• Ability to be a resource for coding guidelines.
• Ability to communicate effectively verbally and in writing.

ENVIRONMENTAL WORKING CONDITIONS
• Normal office environment. This is a remote position

PHYSICAL/MENTAL DEMANDS
• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard

ESSENTIAL FUNCTIONS