Certified Professional Coder- Orthopedic

Tryon Medical Partners; Charlotte (NC); Hybrid; USD 65,000 - 85,000; Full time

Job summary

Tryon Medical Partners in North Carolina seeks a Certified Professional Coder- Orthopedic to accurately interpret and bill physician charges by entering CPT, ICD-10 and modifiers into the TMP billing system. This full-time hybrid or remote position supports the RCM team, Monday to Friday 8 am to 5 pm.

Coding certification is required; CPC certification preferred. You will review charts, assign codes, query physicians as needed, and ensure AMA guideline and payer rule compliance.

Qualifications

• Minimum 3 years’ CPT and ICD-10 coding experience.
• CPC Certification required; active CEUs during employment tenure.
• Advanced knowledge of medical terminology, anatomy, and physiology.
• Familiarity with payer rules, coding, bundling, and modifiers.
• Understanding of NCDs and LCDs and related regulatory guidelines.

Responsibilities

• Performs initial charge review to determine appropriate ICD-10 and CPT codes.
• Interprets medical documents to assign CPT and ICD-10 codes per AMA guidelines.
• Enter data into the TMP billing system with correct codes and modifiers.
• Adheres to guidelines for timeliness of processing charges and communicates with team.
• Queries physicians to ensure proper coding of procedures.
• Reviews patient logs and clinical activity to ensure billing capture.
• Ensures compliance with third-party and regulatory guidelines.
• Collaborates with Reimbursement staff on coding and billing inquiries.

Skills

CPT ICD-10 coding

Medical terminology

Regulatory guidelines

Communication

Education

High school diploma or GED

CPC Certification

Tools

TMP billing system

Job description

Certified Professional Coder- Orthopedic

Job Summary:

The Certified Professional Coder performs various duties to accurately interpret and bill physician charges for physician services by entering into the appropriate CPT, ICD-10, and modifiers into the Billing system.

(This is a full-time hybrid or remote position that will support the RCM team, Monday to Friday 8 am to 5 pm-

Coding certification required)

Primary Job Responsibilities/Tasks may include, but not limited to:

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third party payers.
• Interprets progress notes, operative reports, discharge summaries, and charge documents to determine services provided and accurately assign CPT and ICD-10 coding to these services, according to guidelines established by the AMA.
• Enter appropriate data into the TMP billing system by selecting the appropriate codes, diagnosis, modifiers, to complete the charge process.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Contacts physicians through query protocols regarding procedures and other services billed to ensure proper coding.
• Responsible for reviewing patient logs and other report of clinical activity to ensure billing is captured for all patients.
• Reviews all physician documentation to ensure compliance with third party and regulatory guidelines.
• Works in conjunction with the Reimbursement staff to answer all inquiries regarding coding and billing for TMP physicians' services.
• Performs other related duties as required and assigned.

Requirements:

Education and Certifications:

• High school diploma or GED completion is required.
• A minimum of three (3) years’ experience with CPT and ICD-10 coding of physician services required.
• Coding certification required. CPC Certification preferred. Must maintain active certification and required CEUs during employment tenure.
• Advanced working knowledge of medical terminology, anatomy, and physiology required.
• Knowledge of and the ability to apply payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• Understanding of and familiarity with regulatory guidelines including NCDs and LCDs.

Experience:

• Family Practice, Internal Medicine, Cardiology, Rheumatology, Endocrinology, Gynecology, and Dermatology preferred.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Advanced knowledge of the ICD-10 CM/PCS and CPT/HCPCS coding systems and conventions.
• Advanced knowledge of, but not limited to, Official Coding Guidelines and methodologies.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team concept.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.

Physical Requirements:

• Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
• Must be able to lift and support weight of 35 pounds.
• Ability to concentrate on details.
• Use of computer for long periods of time.