Orthopedic Coding & Precertification Leader

Staff Financial Group; Atlanta (GA); On-site; USD 100,000 - 115,000; Full time

Job summary

Staff Financial Group is seeking an experienced Orthopedic Coding & Precertification Manager to oversee coding operations, surgical authorizations, and revenue cycle performance for a growing orthopedic organization.

The role requires leadership, CPC certification, and a proactive approach to improve accuracy, compliance, and denial prevention while supporting patient access and operational efficiency.

Qualifications

• Minimum 5 years of orthopedic coding, revenue cycle management, surgical authorizations, or related healthcare reimbursement operations.
• Minimum 2 years of leadership, management, or supervisory experience.
• Certified Professional Coder (CPC) certification required.
• Strong knowledge of orthopedic surgical coding, precertification, payer authorization requirements, and revenue cycle operations.
• Advanced understanding of CPT, HCPCS, ICD-10-CM, NCCI edits, modifiers, medical necessity, and global surgery rules.
• Familiarity with commercial insurance, workers' compensation, and third-party payer requirements.
• Experience with coding audits, authorization workflows, denial prevention, appeals, and reimbursement processes.
• Strong analytical, organizational, problem-solving, and communication skills.
• Proficiency in Microsoft Excel, practice management systems, EHR platforms, and healthcare reporting tools.

Responsibilities

• Oversee orthopedic coding and documentation integrity.
• Lead surgical and procedural authorization processes to ensure timely approvals.
• Monitor coding-related charge lag and unbilled charges; ensure accurate charges before billing.
• Partner with Accounts Receivable leadership to analyze denials and implement corrective actions.
• Supervise, coach, and develop coding and precertification professionals.
• Educate providers and staff on documentation requirements, coding standards, and payer expectations.

Skills

Analytical

Leadership

Communication

Problem-solving

Organizational

Education

CPC certification

Bachelor's degree in Healthcare Administration or related field

Tools

Power BI

Epic

NextGen

athenahealth

eClinicalWorks

Microsoft Excel

Job description

Staff Financial Group is seeking an experienced Orthopedic Coding & Precertification Manager to oversee coding operations, surgical authorizations, and revenue cycle performance for a growing orthopedic organization.

The role requires leadership, CPC certification, and a proactive approach to improve accuracy, compliance, and denial prevention while supporting patient access and operational efficiency.