Senior Coding Operations Specialist

Job Title

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

Equal Opportunity Employer

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