Medical Coding Specialist

Orthoillinois, a Division of Orthomidwest; Rockford (IL); On-site; USD 42,000 - 54,000; Full time

Job summary

Orthoillinois, a Division of Orthomidwest, is seeking a Medical Coding Specialist to ensure accurate charge capture for all providers and services. You will code using CPT, ICD-10, and HCPCS guidelines, enter charges in the EHR, and review dictations for accuracy.

The role requires two years of related experience, knowledge of medical terminology, and ongoing education to maintain CPC certification. Office-based environment with standard clinics and facilities.

Qualifications

• High school diploma or GED required.
• Minimum two years of experience in a similar role.
• Understanding CPT, ICD-10, HCPCS coding requirements; professional coding certification preferred.
• Understanding of medical terminology.
• Basic working knowledge of Microsoft and Google Suites.
• Basic working knowledge of EHR and insurance/hospital portals.

Responsibilities

• Retrieve information from medical records for billing using CPT and ICD-10 guidelines.
• Review daily charge capture for providers/ancillary services.
• Review claims requiring follow-up appeal.
• Analyze operative reports to assign CPT/ICD-10/HCPCS codes and modifiers.
• Enter codes/charges in the EHR system.
• Audit provider dictation for compliance and accuracy.
• Handle incoming patient and internal coding issues.
• Maintain CPC certificate through continuing education.

Skills

CPT coding

ICD-10 coding

HCPCS coding

Medical terminology

Microsoft Suite

Google Suite

EHR systems

Insurance portals

Education

High School Diploma or GED

2 years experience in similar role

Professional Coding Certification preferred

Understanding of medical terminology

Tools

EHR system

Insurance portals

Job description

Department: Billing Reports To: Manager, Billing and Coding

FLSA: Non-Exempt

Job Purpose:

The Medical Coding Specialist is responsible for daily charge capture for all assigned providers and/or ancillary services ensuring correct coding guidelines are followed.

Primary Duties and Responsibilities:

• Retrieves relevant information from medical records for appropriate billing using current CPT and ICD 10 code guidelines
• Reviews daily charge capture for all assigned Providers/Ancillary Services
• Reviews claims requiring follow-up appeal
• Analyzes operative reports to assign correct CPT, ICD 10, HCPCS codes and modifier usage when capturing surgery charges
• Enters codes/charges in EHR system
• Audits provider dictation for compliance and accuracy
• Handles incoming patient and internal issues regarding coding
• Ensures compliance with medical coding policies and guidelines, including attending webinars, conferences, and maintaining CPC certificate through continuing education

Competencies:

• Service: We align our actions and decision making with the organization’s guiding platform keeping our patients at the center of all we do.
• Change Agent: We support and contribute to positive change in the organization.
• Communication and Interpersonal Relations: We communicate honestly and with compassion to build connections with our patients and each other.
• Effectiveness: We take ownership of work, doing the right thing for our customer and doing it well.

Organizational Culture:

All OrthoIllinois employees focus on service by putting the mission, vision, and value statements into practice and using the guiding principles of Compassion, Respect, Trust, Integrity, Innovation, Education Fiscal Responsibility, Practice Independence, Accountability, and Empowerment to direct their interactions and decision making. Employees promote and model the service standards to create lasting impressions, extraordinary moments, exceptional on-stage experiences, and meaningful and compassionate connections.

Education and Experience Requirements:

• High School Diploma or GED
• A minimum of two years of experience in a similar position and/or performing similar tasks
• Understanding of CPT, ICD 10, HCPCS coding requirements; professional Coding certification preferred
• Understanding of medical terminology
• Basic working knowledge of Microsoft and Google Suites
• Basic working knowledge of EHR and insurance and hospital portals

Environmental/Working Conditions:

Working environment is in an office/clinic setting.

Physical/Mental Demands:

• Sit, stand, walk, stoop or kneel, crouch or crawl, and climb stairs for long periods of time
• Requires lifting, carrying and/or moving objects in a manner consistent with most office environments (generally, no more than 10 pounds on a frequent basis and 20 pounds on an occasional basis)
• Possess full range of motion in shoulders and arms, including reaching above or below the shoulder
• Finger dexterity; the ability to twist hands/wrists repetitively
• Vision (e.g., depth perception, color vision, strong vision up close), hearing (e.g., high pitch sounds, soft or distant sounds)

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.