Certified Ophthalomology Coder

Position Summary Is seeking an experienced and detail oriented Certified Ophthalmology Coder to join our growing team. The ideal candidate will have extensive knowledge of ophthalmology coding, insurance guidelines, modifier usage, surgical coding, and claim submission requirements for both professional and ASC services. This position plays a critical role in ensuring accurate coding, compliance, timely claim submission, and optimal reimbursement. Responsibilities Review and accurately code ophthalmology office visits, diagnostic testing, injections, laser procedures, and surgeries Assign appropriate CPT, ICD-10, HCPCS, modifiers, and revenue codes when applicable Review operative reports and medical documentation for coding accuracy and completeness Submit corrected claims and resolve coding-related claim denials Ensure compliance with Medicare, Medicaid, commercial payer, and ASC billing guidelines Work closely with providers, billing staff, and management regarding coding updates and documentation requirements Audit encounters for coding accuracy and identify missed revenue opportunities Maintain current knowledge of payer policies and ophthalmology coding changes Assist with appeals and coding-related insurance inquiries Maintain confidentiality and HIPAA compliance at all times Qualifications Certified Professional Coder (CPC), Certified Ophthalmic Coding Specialist (OCS), or equivalent certification required Minimum of 3 years of ophthalmology coding experience preferred Strong knowledge of: Retina, glaucoma, cataract, cornea, and pediatric ophthalmology coding Surgical coding and global periods Modifier usage including

• 25,•59,•79, RT/LT, and others Injection coding and J-code billing Medicare and commercial payer guidelines ASC and professional claim billing requirements Experience with EHR/PM systems preferred Strong attention to detail and problem-solving skills Ability to work independently and meet productivity goals Excellent communication and organizational skills Preferred Experience Experience coding for both physician office and ambulatory surgery center (ASC) Knowledge of ophthalmic diagnostic testing including OCT, visual fields, fundus photography, and biometry Familiarity with claim scrubbing, denials management, and payer audits Benefits Competitive pay based on experience Paid time off Health benefits How to Apply Please submit your resume along with your coding certification and ophthalmology coding experience for consideration.

Application Question(s): Please describe your experience with ophthalmology coding, including the specialties you have coded for (retina, glaucoma, cataract, cornea, ASC, etc.) and the coding certifications you currently hold. How do you determine the correct use of modifiers such as

• 25,•59,•79, RT/LT, and global surgery rules when coding ophthalmology office visits and surgical procedures?

Please provide an example. Describe your experience working denied or rejected claims. What steps do you take to research the issue, correct the claim, and ensure proper reimbursement from Medicare or commercial insurance payers?

Work Location:

In person