Coder

Excelsior Orthopaedics Group; Buffalo (NY); On-site; USD 55,000 - 75,000; Full time

Job summary

Excelsior Orthopaedics Group is seeking a Medical Coder to review and assign CPT, ICD-10, and HCPCS codes for orthopedic cases. You will audit physicians’ notes, ensure compliance with payer rules, and collaborate with billing to resolve issues.

Required CPC/CCS certification and 1+ year coding experience, with both independent and team-work capability in a fast-paced setting. Familiarity with EHR/EMR systems and Microsoft Office is expected.

Qualifications

• Associates degree preferred; HS diploma or GED required.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification is required.
• Proven experience (1+ years) as a coder or in a similar role.
• Demonstrated ability and understanding of an electronic health record (EHR/EMR) and coding software is preferred.
• Knowledge of orthopedic, physical therapy, or podiatry medical terminology is desirable.
• Ability to work independently and collaboratively in a fast-paced, team-oriented environment.
• Computer skills required with minimum proficiency in Microsoft Word, Excel, Outlook, and Teams.

Responsibilities

• Review and audit physician documentation to accurately assign diagnosis and procedure codes for orthopedic services.
• Ensure coding practice meets federal and state guidelines, payer-specific requirements, and company policies.
• Communicate with providers and clinical staff to ensure accurate documentation to produce accurate coding.
• Monitor coding edits, denials, and rejections; assist in appeals and corrections as needed.
• Collaborate with the billing team to resolve coding and reimbursement issues.
• Stay current with coding guidelines, orthopedic-specific regulations, and payer updates.
• Accurately enter and itemize charge data into the billing system.

Skills

One+ year coding experience

Work independently

Collaborative team player

Excel basics

Word basics

Education

Associate degree preferred

HS diploma or GED required

Tools

EHR/EMR software

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft Teams

Job description

Job Summary

The Coder is responsible for reviewing, interpreting, and assigning appropriate CPT, ICD-10, and HCPCS codes, and ensuring compliance with federal regulations and payer policies. This position is responsible for reviewing operative reports for all procedures performed by Excelsior Orthopaedic Physicians for completeness and to abstract and code clinical data, using standard classification systems.

Duties and Responsibilities

• Demonstrate our core values of being patient centered, team focused, service driven, accountable, and innovative every day.
• Review and audit physician documentation and surgical reports to accurately assign diagnosis and procedure codes for orthopedic services, including office visits, imaging, physical therapy, and surgical procedures.
• Ensuring coding practice meets federal and state guidelines, payer-specific requirements, and company policies.
• Communicate with providers and clinical staff to ensure accurate documentation to produce accurate coding.
• Monitor coding edits, denials, and rejections; assist in appeals and corrections as needed.
• Collaborate with the billing team to resolve coding and reimbursement issues.
• Stay current with coding guidelines, orthopedic-specific regulations, and payer updates.
• Accurately enter and itemize charge data into the billing system, ensuring completeness and adherence to internal policies.
• Assist with verifying and applying correct CPT, ICD-10, and HCPCS codes based on provider documentation; elevate complex coding issues to certified coders when needed.
• Prepare, process, and transmit insurance claims (electronic and paper) in accordance with payer requirements and deadlines.
• Collect and verify all the information necessary to complete the billing process, including patient demographics, insurance coverage, and provider charge details.
• Evolve in your role when performing supplemental responsibilities as assigned.

Requirements and Qualifications

• Associates degree preferred; HS diploma or GED required.
• Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent coding certification is required.
• Proven experience (1+ years) as a Coder or in a similar role required.
• Demonstrated ability and understanding of an electronic health record (EHR/EMR) and coding software is preferred.
• Knowledge of orthopedic, physical therapy, or podiatry medical terminology is desirable.
• Ability to work independently and collaboratively in a fast-paced, team-oriented environment.
• Computer skills required with minimum proficiency in Microsoft Word, Excel, Outlook, and Teams.

Physical Demands

• Manual and finger dexterity and eye-hand coordination to enter data and operate office equipment
• Corrected vision and hearing within normal range to observe and communicate with patients, providers, and staff.
• Frequently remaining in a stationary position, often sitting for prolonged periods working on a computer, telephone, copy/fax machine, and other office equipment
• Occasional standing and walking required
• Occasional lifting and carrying items weighing up to 10 pounds.

The pay range for this position is determined based on several factors, including the candidate's years of experience, qualifications, training, licenses, designations, and the overall market conditions.

This job description does not state or imply that the duties and responsibilities listed are the only ones required of this position. Team members in this role will be required to perform other job-related duties at the discretion of the employer and may have additional duties assigned as necessary.

Excelsior Orthopaedics and Buffalo Surgery Center are committed to the full inclusion of all applicants. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information.