Senior Medical Coder

Medpoint Partners; Atlanta (GA); On-site; USD 100,000 - 115,000; Full time

Benefits offered by this job

Excellent benefits

Generous PTO

Job summary

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

The ideal candidate combines advanced orthopedic coding expertise with leadership, analytics, and a proactive approach to process improvement, denial prevention, and compliance with CPT, ICD-10-CM, and payer guidelines.

Qualifications

• Minimum 5 years in orthopedic coding or related reimbursement operations.
• Minimum 2 years in leadership or supervisory roles.
• CPC certification is required.
• Strong knowledge of CPT, ICD-10-CM, NCCI, and payer rules.

Responsibilities

• Oversee orthopedic coding and documentation integrity across procedures.
• Manage surgical authorizations to ensure timely approvals.
• Monitor revenue cycle performance and denial prevention.
• Lead audits and implement corrective actions.
• Coach and develop coding and precertification staff.
• Collaborate with surgeons and payers to optimize workflows.

Skills

Leadership

Analytical skills

Communication

Excel

EHR platforms

Healthcare reporting

Education

CPC certification

Bachelor’s degree in Healthcare Administration or related

Tools

Epic

NextGen

athenahealth

eClinicalWorks

Power BI

Job description

Salary: $100k-$115k base plus incentive, excellent benefits, generous PTO

We are seeking an experienced Orthopedic Coding & Precertification Manager to oversee coding operations, surgical authorizations, documentation integrity, and revenue cycle performance for a growing orthopedic healthcare organization.

This position plays a critical role in ensuring orthopedic clinical and surgical services are coded accurately, authorizations are secured promptly, and billing processes operate efficiently while maintaining compliance with regulatory and payer requirements.

The ideal candidate combines advanced orthopedic coding expertise with strong leadership capabilities, analytical skills, and a proactive approach to process improvement, denial prevention, and revenue optimization.

Key Responsibilities

Orthopedic Coding & Documentation Integrity

• Oversee accurate coding of orthopedic procedures, including joint replacements, arthroscopy, spine, sports medicine, trauma, fracture care, and injections.
• Ensure compliance with CPT, HCPCS, ICD-10-CM, CMS, NCCI, and payer-specific guidelines.
• Monitor modifier usage, medical necessity, diagnosis specificity, laterality, and global surgery requirements.
• Collaborate with providers to address documentation deficiencies and improve coding accuracy.
• Lead surgical and procedural authorization processes to ensure timely approvals and minimize patient care delays.
• Monitor payer-specific authorization requirements and documentation standards.
• Identify and resolve authorization barriers before scheduled procedures.
• Improve workflows to reduce authorization-related denials and reimbursement delays.

Revenue Integrity & Denial Prevention

• Monitor coding-related charge lag, unbilled charges, and authorization discrepancies.
• Ensure coding and authorization requirements are satisfied before claims are released for billing.
• Partner with Accounts Receivable leadership to analyze coding- and authorization-related denials.
• Implement corrective actions, staff education, and process improvements to prevent recurring issues.
• Identify opportunities to reduce revenue leakage and improve reimbursement performance.
• Provide coding and authorization expertise to support account resolution and appeals.
• Supervise, coach, and develop coding and precertification professionals.
• Establish and monitor productivity, quality, and performance expectations.
• Manage staffing, workload distribution, training, and accountability.
• Foster a culture of continuous improvement, collaboration, and operational excellence.
• Partner with orthopedic surgeons, advanced practice providers, clinical staff, and revenue cycle leadership.
• Educate providers and staff on documentation requirements, coding standards, and payer expectations.
• Conduct internal coding and authorization audits to identify compliance risks.
• Develop corrective action plans and track key operational and financial performance indicators.
• Support departmental initiatives and strategic improvement priorities.

Qualifications

Required Qualifications

• Minimum 5 years of experience in 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.

Preferred Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, or a related field; equivalent experience considered.
• Experience in an orthopedic physician practice, multi-location orthopedic organization, ambulatory surgery center (ASC), or high-volume surgical environment.
• Background in professional fee billing, surgical coding, payer contract analysis, and revenue cycle analytics.
• Experience with Epic, NextGen, athenahealth, eClinicalWorks, or comparable platforms.
• Experience with Power BI or other business intelligence tools.
• Additional certifications such as COCS, CPMA, COC, CIC, CPC-H or equivalent, CRCR, or CPB.