Surgical Case Reviewer: Certified Coder (F/T) - Remote

Optim Health System; Savannah (GA); Remote; USD 60,000 - 90,000; Full time

Job summary

A leading medical practice is looking for a Surgical Case Reviewer: Certified Coder to join their team. The successful candidate will work remotely and be responsible for reviewing surgical orders in various focus areas, ensuring proper documentation and compliance with payer guidelines. This mid-senior level role requires a Certified Professional Coder with a proven track record in improving coding accuracy and collaborating with multi-disciplinary teams.

Qualifications

• Certified Professional Coder with three or more years of experience.
• Ability to stay current on coding guidelines.
• Meets or exceeds industry standards with 95% accuracy.

Responsibilities

• Review all surgical orders for documentation and coding accuracy.
• Communicate and educate surgical teams on discrepancies.
• Work with clinical revenue to address medical necessity denials.

Skills

Medical Necessity reviews

Communication

Working with Multi-disciplinary teams

Attention to detail

Education

Certified Professional Coder

Tools

Electronic Health Records

Job description

Surgical Case Reviewer: Certified Coder (F/T) - Remote

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Surgical Case Reviewer: Certified Coder (F/T) - Remote

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Optim Health System is seeking (2) full time Surgical Case Reviewer: Certified Coder(s). This is a remote position.

JOB TITLE: Surgical Case Reviewer: Certified Coder

SUPERVISION RECEIVED: Reports directly to Patient Access Director

SUPERVISION EXERCISED: None

TYPICAL WORKING CONDITIONS: Remote

ESSENTIAL DUTIES AND RESPONSIBILITIES: (This list may not include all of the duties assigned.)

• Review all surgical orders submitted for All Optim facilities
• Focusing on Orthopedic, Neuro Spine, Ortho Spine, Sports Medicine, Pain Management
• Orders reviewed for appropriate documentation and coding; feedback given to physicians on any discrepancies
• Medical Necessity reviews according to payer guidelines
• Communication and education with Surgeons and Surgical teams
• Works with Multi-disciplinary teams to ensure codes on order and precertification are accurate and complete
• Ability to stay current on all relevant coding guidelines as well as payer requirements
• Meets or exceeds industry standard production levels and maintains 95% accuracy in quality assurance reviews
• Experience with electronic health records
• Assisting Clinical Revenue with Medical Necessity denials
  
  

CERTIFICATE/LICENSE: Certified Professional Coder with three or more years of experience in focus fields listed above.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Administrative

• Industries

  Medical Practices

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