ORTHOPEDIC/SPINE SURGICAL CODER

Flagstaff Bone and Joint; Flagstaff (AZ); Hybrid; USD 53,000 - 65,000; Full time

Benefits offered by this job

Medical Insurance

HSA

Dental Insurance

Vision Insurance

Telehealth

Life Insurance

Short-Term Disability

401(k) Plans

Paid Time Off

Holidays

Employee Care Credit

Job summary

Flagstaff Bone and Joint is seeking a Coding Specialist to manage ICD-10-CM, CPT, and HCPCS coding, billing and denials for orthopedic and spine cases. The role emphasizes accuracy, adherence to coding guidelines, and collaboration with the Revenue Cycle team in Flagstaff.

The position requires CPC certification and surgical billing experience, with familiarity across Commercial, Medicare and Medicaid plans.

Qualifications

• Must have orthopedic/spine coding experience and the ability to review and natively code complex operative procedure reports.
• CPC certification and surgical billing experience as well as claims adjudication experience are required.
• Must have experience with Commercial, Medicare, Medicaid, and secondary insurance plans.
• Must be able to adequately communicate and coach providers on proper billing practices.
• Must be familiar with current coding trends including ICD-10.
• Skills in establishing and maintaining effective working relationships with patients, medical staff, and the public.
• Work at an efficient and fast pace and be self-motivated.
• Must be highly organized and have excellent attention to detail.

Responsibilities

• Analyze and interpret medical information in the medical record and assign/sequence the correct ICD-10-CM, CPT, and/or HCPCS code to the diagnoses/procedures of office, inpatient and/or outpatient medical records, including operative reports, according to established coding guidelines.
• Enter surgical charges in accordance with National Correct Coding Edits, applying correct modifiers and ICD-10 codes for accurate and compliant coding.
• Interact with and provide support to the practice to answer questions and resolve claim denials.
• Utilize resources and contacts to research coding issues and maintain knowledge of payment/reimbursement systems to ensure maximum reimbursement and coding compliance.
• Identify opportunities for billing/coding improvements and participate in developing programs for coding compliance monitoring and physician documentation improvement.
• Meet or exceed productivity and quality standards as assigned by management.
• Take responsibility for various projects and perform duties as requested by management within scope of knowledge/ability.
• Work as a team player and communicate positively with coworkers, managers, providers, and other contacts.

Skills

Orthopedic/spine coding

CPC certification

Surgical billing

Claims adjudication

Athena experience

Education

CPC certification

Tools

Athena

Job description

Coding Specialist

General Summary of Duties

Responsible for coding, billing, denials, accounts receivable and payer policy updates.

Supervision Received

Reports to Revenue Cycle Manager.

Education

CPC certification required.

Pay

$53,000 - $65,000 /annual salary (DOE).

Location

Flagstaff office (Remote considered).

Responsibilities

• Analyze and interpret medical information in the medical record and assign/sequence the correct ICD-10-CM, CPT, and/or HCPCS code to the diagnoses/procedures of office, inpatient and/or outpatient medical records, including operative reports, according to established coding guidelines.
• Enter surgical charges in accordance with National Correct Coding Edits, applying correct modifiers and ICD-10 codes for accurate and compliant coding.
• Interact with and provide support to the practice to answer questions and resolve claim denials.
• Employ strong understanding of the encounter/billing process, and working knowledge of a Medicare, Commercial, and all other insurance plans as well as, their impact on reimbursement. Utilize medical reference resources and contacts to thoroughly research coding issues and to maintain working knowledge of payment/reimbursement systems to ensure maximum reimbursement and coding compliance.
• Identify opportunities for billing/coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.
• Meet or exceed productivity and quality standards as assigned by management.
• Take responsibility for various projects as assigned by management and perform any additional/miscellaneous duties (not inclusive of job description) as requested by the management team within the scope of knowledge/ability.
• Work as a team player and communicate in a positive manner with co-workers, managers, providers, and other contacts.

Requirements

• Must have orthopedic/spine coding experience and the ability to review and natively code complex operative procedure reports.
• Athena experience preferred.
• Must have CPC certification and surgical billing experience as well as claims adjudication experience.
• Must have experience with working with Commercial, Medicare, Medicaid, and secondary insurance plans.
• Must be able to adequately communicate and coach providers on proper billing practices.
• Must be familiar with current coding trends including ICD 10.
• Skills in establishing and maintaining effective working relationships with patients, medical staff, and the public.
• Work at an efficient and fast pace.
• Must be self-motivated.
• Must be highly organized and have excellent attention to detail.
• Skills in exercising initiative, judgment, discretion, and decision-making to achieve organizational objectives.

Physical/Mental Demands

Sitting/standing for 8-9 hours a day. Must be able to view computer screen for long periods. Requires hand-eye coordination and finger dexterity. Occasional stress related to workload and assisting patient/staff/physicians with problems.

About Us

Since 1978, Flagstaff Bone and Joint has helped people across Northern Arizona move better, feel better, and return to the lives they love. As a successful, physician-owned orthopedic and spine practice, we combine high-quality musculoskeletal care with a workplace where employees are valued, supported, and encouraged to grow. Our collaborative, fast-paced teams share a commitment to respecting patients' time and money while fostering a culture of excellence. If you are looking for meaningful work, opportunities to build your healthcare career, and a fun, dedicated team, we invite you to grow with FBJ.

Why You'll Enjoy Working at FBJ

• Supportive, ambitious teams that work hard, collaborate, and celebrate success together
• Modern and beautiful office setting
• Growth and professional development opportunities
• Regular social events
• On-the-job training
• A positive employee culture built on teamwork, recognition, and opportunities to grow
• Caring, compassionate leadership that values clear and transparent communication

Benefits That Support You—At Work and Beyond

• Medical Insurance – Cigna Healthcare (must work 30 hrs / week or more)
• Medical benefits begin the first of the month following 60 days
• Health Savings Account (H.S.A.)
• Voluntary Dental Insurance
• Voluntary Vision Insurance
• Telehealth medical care
• Voluntary Life Insurance
• $50,000 in employer-paid group life insurance at no cost to employees
• Voluntary Short-Term Disability
• 401(k) and Roth 401(k) retirement plans, after one year of employment
• Eight paid days off for holidays
• Paid time off begins immediately
• 80 hours of PTO in your first year, with 120 hours provided to you on your anniversary date
• $500 credit to be used at FBJ, if you or your family needs care with us

Finalization of hiring is contingent on a clear background check.

Who We Are

We are a well-established, private practice providing quality musculoskeletal care to Northern Arizona since 1978. Our center strives to provide state-of-the-art care along with comprehensive medical education and superior customer service. Our main location is in Flagstaff, and our secondary location is in Kingman, Arizona. We have 2 other Arizona clinic locations: Cottonwood and Show Low. Flagstaff Bone and Joint has 20 medical providers with 8 physicians who are all Board Certified and Fellowship trained. Our center provides integrated ancillary services for patient convenience including digital x-ray, ultrasound, custom bracing, durable medical equipment, EMG/nerve conduction studies, and occupational and physical therapy. A talented team of 115 employees committed to exceptional patient care.

Our Purpose

Always respect patients' time and money while fostering a culture of excellence.