Coding Team Lead (Orthopedics)

Ventra Health, Inc.; Chennai District; On-site; INR 5,730,658 - 8,595,988; Full time

Benefits offered by this job

Incentive program

Job summary

Ventra Health, Inc. is seeking an Orthopedic Team Lead to oversee accurate review and coding of orthopedic encounters, ensuring compliance with current guidelines. The role involves identifying incomplete documentation, communicating with providers, and processing codes within set turnaround times.

The position also requires reviewing denied claims, identifying coding discrepancies, and implementing corrections to support reimbursement. Collaboration with QA and coding staff is essential.

Qualifications

• At least one year in medical billing preferred.
• In-depth knowledge of CPT/ICD-10 coding system.
• Knowledge of health information documentation.
• In-depth knowledge of medical terminology.

Responsibilities

• Review orthopedic medical records to accurately identify procedures and diagnoses.
• Audit coded orthopedic encounters to identify inaccuracies and implement corrections.
• Collaborate with QA team to review audit findings.
• Identify incomplete or inaccurate provider documentation and communicate findings via Smartsheet.
• Maintain Smartsheet by documenting updates, tracking issues, and communicating with clients.
• Maintain internal orthopedic coding guidelines aligned with current standards.
• Ensure all encounters are coded daily and processed within turnaround times.
• Review denied orthopedic claims to identify discrepancies and correct with documentation.
• Provide training and support to coding staff.
• Conduct routine quality assurance audits for accuracy and compliance.

Skills

Medical billing experience

CPT/ICD-10 coding

Health information knowledge

Medical terminology

Education

1 year medical billing experience preferred

Tools

Smartsheet

Outlook

Excel

Word

Job description

About Us

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

• As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards

Job Summary

The Orthopedic Team Lead is responsible for overseeing the accurate review and coding of orthopedic encounter documentation, ensuring all procedures and diagnoses are properly identified and captured. This role ensures that all encounters are coded accurately and in compliance with the most current coding guidelines and regulatory standards. The Orthopedic Team Lead must be proficient in identifying incomplete, unclear, or inaccurate clinical documentation and proactively communicate with providers or staff to obtain clarification, ensuring compliant and high‑quality coding practices. Timeliness is essential; therefore, the Orthopedic Team Lead ensures that all encounters are coded and processed within established turnaround times. The role also includes reviewing orthopedic claims denied by insurance payers, identifying potential coding discrepancies, and implementing necessary corrections to support accurate claim resubmission and reimbursement.

Essential Functions and Tasks

• Review orthopedic medical records to accurately identify all procedures and diagnoses
• Audit coded orthopedic encounters to identify inaccuracies and implement necessary corrections
• Collaborate with the QA team to review and discuss audit findings
• Identify incomplete or inaccurate provider documentation and communicate findings via Smartsheet
• Maintain Smartsheet by documenting updates, tracking issues, and communicating directly with clients regarding patient accounts
• Maintain internal orthopedic coding guidelines, ensuring alignment with current industry standards and updates
• Ensure all orthopedic encounters are coded daily and processed within established turnaround times
• Review denied orthopedic claims to identify coding discrepancies and implement appropriate corrections using supporting documentation
• Participate in team development by providing training and support to coding staff
• Conduct routine quality assurance audits to ensure accuracy, compliance, and adherence to organizational standards

Education and Experience Requirements

• At least one year in medical billing preferred
• In depth knowledge of CPT/ICD‑10 coding system
• Knowledge of health information documentation
• In depth knowledge of medical terminology

Knowledge, Skills, and Abilities

• Basic use of computer
• Basic knowledge of Outlook, Word and Excel
• Understand and comply with company policies and procedures

Compensation

• Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job‑related reasons.
• This position is also eligible for a discretionary incentive bonus in accordance with company policies.

Equal Employment Opportunity (Applicable only in the US)

Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.