Orthopedic Coding Specialist: Complex Procedures

Spire Orthopedic Partners; Turn of River (CT); On-site; USD 85,000 - 120,000; Full time

Job summary

Spire Orthopedic Partners is seeking a Certified Coding Specialist to ensure accurate and compliant coding of complex orthopedic procedures across all care settings. The role focuses on CPT/ICD-10 coding accuracy, minimizing denials, and supporting documentation improvement with surgeons and RCM teams.

Responsibilities include reviewing high-complexity procedures, validating documentation, applying payer rules, conducting pre-bill audits, and leading coding quality initiatives with vendor

Qualifications

• 5+ years of surgical coding experience
• Deep knowledge of NCCI edits and bundling rules
• Experience with orthopedic or multi-specialty groups preferred

Responsibilities

• Code high-complexity orthopedic and neurosurgical procedures
• Review coding-related denials and perform root cause analysis
• Perform targeted pre-bill audits for high-dollar surgeries
• Lead Provider Documentation Improvement initiatives with surgeons
• Audit external coding vendor performance and enforce standards

Skills

Surgical coding

CPT/ICD-10

NCCI edits

Modifier usage

Education

CPC/CCS certification

Tools

ModMed

athenahealth

Job description

Spire Orthopedic Partners is seeking a Certified Coding Specialist to ensure accurate and compliant coding of complex orthopedic procedures across all care settings. The role focuses on CPT/ICD-10 coding accuracy, minimizing denials, and supporting documentation improvement with surgeons and RCM teams.

Responsibilities include reviewing high-complexity procedures, validating documentation, applying payer rules, conducting pre-bill audits, and leading coding quality initiatives with vendor