GENERAL STATEMENT OF DUTIES

Position is primarily responsible for reviewing operative reports and documentation for surgery and all other facility-based charges; assigning appropriate CPT and ICD-10 codes and entering charges into the practice management system. Reviewing and auditing charge tickets for office services. Checks for correctness and completeness prior to tickets being processed for billing and claim submission. Work as a resource for the charge posters with coding questions as well as the A/R team regarding correct processing of claims and assisting with appeals.

Schedule:

Monday-Friday 8am-5pm (no weekends)

Benefits:

401(k) matching + profit sharing Health/Dental/Vision Insurance FSA/HSA options Life insurance/AD&D/STD/LTD Paid time off

Employee Discount Program Wellness Program Department Duties/Responsibilities:

Read and interpret medical record documentation to identify all diagnoses and significant procedures that are to be coded, for all facility-based charges and enter them into the practice management system. Reviews, audits and corrects charge tickets with respect to appropriate CPT and ICD-10 codes including modifiers to accurately represent the services provided, maximize reimbursement and facilitate the audit/review process. Contact physicians for clarification when needed, to ensure accurate charge entry. Review and code surgical pre-certs sent thru Athena for upcoming surgeries. Ensure all codes coded have been correctly pre-certified, if not send back to the secretary in Athena for updated retro authorization. Apply federal guidelines in the coding of patient diagnoses and procedures according to CPT/HCPCS and ICD-10 coding conventions. Assist Billing Department with claims resolution, i.e., verifying and correcting all coding issues. Review denials and coverage policies Provide coding support to all departments within the practice. Review op reports and audit all Surgeries over $10,000. Work in the coding review Q- to assist AR Staff with Surgical coding questions and appeals, as assigned. Be open to any research projects that may involve coding/ Reimbursement issues. Audit E & M chart notes as assigned. Perform other related duties that may be inclusive, but not listed in the job description

Physical Requirements:

The physical demands described here are representative of those an individual must meet to successfully perform the essential functions of this job. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions. Ability to work in a fast-paced office environment Strong sensory skills, such as visual acuity, good hearing, and dexterity Ability to stand and sit for periods of time and to move constantly throughout the workday Good speaking and listening skills Ability to perform focused work with close attention to detail Ability to operate office equipment, including computers, copiers, fax machines, and phones Ability to interact with others, both in person and through phone, e-mail, and written correspondence Ability to push, pull, lift, move, and/or carry up to 15 lbs

Education and Experience:

Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Must maintain active certification, remaining in good standing with all certification requirements Minimum of 2 years' experience in private practice required (3+ years highly desirable) High school graduate or equivalent Devoted to teamwork and portraying the company in a very positive manner Organized, accountable, self-motivated, and attentive to detail Excellent written, verbal, interpersonal and communication skills Ability to work under pressure and accurately prioritize problems & initiatives Basic working knowledge of Microsoft Office Suite (Word, Excel, PowerPoint) Minimum of 2 years coding experience in a medical office Knowledge of anatomy and medical terminology Experience and familiarity with medical office billing policies and procedures Knowledge of the following billing software Athena preferred OrthoConnecticut, delivering exceptional care and real results has always been our mission, though we did things a little differently when we opened our doors in 1954. Today, we provide orthopedic care in a new state-of-the-art Musculoskeletal Center of Excellence, in which we provide the full spectrum of high-quality services under one roof. Now we can diagnose and treat the complete range of musculoskeletal issues for all ages in one easily accessible location with minimal wait time and a more efficient patient experience. One thing that hasn't changed since in 1954: our commitment to you OrthoConnecticut is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. The above statement reflects the general duties considered necessary to describe the principal functions of the job as identified and shall not be considered as a detailed description of all the work requirements that may be inherent in the job. 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