Senior Coding Operations Specialist

The CORE Institute | HOPCo; Phoenix (AZ); On-site; USD 65,000 - 90,000; Full time

Job summary

The CORE Institute is seeking an experienced medical coder to join our remote team in Phoenix, AZ. You will oversee coding workflows, ensure accurate CPT/ICD-10-CM coding, and support leadership with complex cases in orthopedics and payer-related coding.

Ideal candidates have 5+ years of professional medical coding experience, AHIMA or AAPC credentials, and strong attention to detail. You will collaborate with physicians and other healthcare professionals while maintaining compliance and quality

Qualifications

• Must be AAPC or AHIMA certified with credentials active
• Minimum 5 years of professional medical coding experience
• Experience with orthopedic surgical coding preferred

Responsibilities

• Monitor backlogs, turnaround times, unresolved encounters, and documentation gaps.
• Reconcile coding work queues, schedules, slips, and charge capture workflows.
• Serve as a senior coding resource for complex procedural and payer-related questions.
• Research and apply CPT, ICD-10-CM, HCPCS, NCCI and payer guidelines.
• Identify trends and risks, and provide recommendations to Coding leadership.
• Support audit trend analysis, root-cause reviews, and education development.
• Assist Coding Manager with special projects and process improvements.
• Escalate staffing or workflow concerns to Coding leadership.
• Provide production coding support as needed.

Skills

Analytical skills

Communication skills

Organizational skills

Independent worker

Education

AAPC/AHIMA certification (CPC, CCS-P, COSC)

Tools

EFS/Charge Capture Systems

Job description

ESSENTIAL FUNCTIONS

• Monitor coding backlogs, turnaround times, unresolved encounters, missing documentation, and workflow exceptions.
• Reconcile coding work queues, surgery schedules, missing slips, EFS/charge capture systems, and other applicable
  workflows.
• Serve as a senior coding resource for complex procedural, surgical, specialty, and payer-related coding questions.
• Research and apply CPT, ICD-10-CM, HCPCS, NCCI, payer policies, and regulatory guidance.
• Identify coding trends, workflow concerns, documentation issues, and areas of risk and provide recommendations to
  Coding leadership/CDI.
• Support audit trend analysis, root-cause review, and development of corrective education.
• Assist the Coding Manager and Supervisors with special projects, workflow reviews, market needs, and process improvement initiatives.
• Escalate staffing or employee workflow and performance concerns to Coding leadership.
• Provide production coding support as needed based on departmental priorities.

EXPERIENCE

• 5+ years of professional medical coding experience, preferably with orthopedic surgical coding. Must be AAPC/AHIMA
  certified with maintained credentials

REQUIREMENTS

• Coding Certification from AAPC/AHIMA (CPC, CCS-P, COSC)

KNOWLEDGE

• Knowledge of medical terminology
• Strong experience reviewing operative reports and complex clinical documentation.
• Advanced knowledge of CPT, ICD-10-CM, HCPCS, modifiers, NCCI edits, and payer guidelines.
• Experience with coding audits, reconciliation, workflow analysis, or coding education preferred.

• Strong analytical, research, organizational, and communication skills.
• Ability to work independently, manage multiple priorities, and serve as a senior coding subject-matter expert.
• The ability to identify and resolve discrepancies in medical records or claims.
• Accuracy is critical in coding, requiring meticulous attention to detail.
• The ability to communicate effectively with physicians and other healthcare professionals.
• Efficiently inputting and managing coding data.

ABILITIES

• Ability to be a resource for coding guidelines.
• Ability to communicate effectively verbally and in writing.

ENVIRONMENTAL WORKING CONDITIONS

• Normal office environment. This is a remote position

PHYSICAL/MENTAL DEMANDS

• Requires sitting and standing associated with a normal office environment.
• Some bending and stretching are required.
• Manual dexterity using a calculator and computer keyboard

ESSENTIAL FUNCTIONS

Equal Opportunity Employer
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