Job Description
Job Description
Description :
JOB TITLE : Surgery Medical Coder
DEPARTMENT : Business Office
REPORTS TO : Coding Manager and Director of Revenue Cycle
FLSA STATUS : Hourly
JOB SUMMARY : The Surgery Medical Coder is responsible for all Endovascular & Neurosurgery coding, accurately assigning CPT, ICD-10, and HCPCS codes for professional services rendered by neurosurgeons, ensuring proper documentation and compliance with federal, state, and payer-specific guidelines. This role requires a highly skilled and detail-oriented individual with at least 2-3 years of experience in neurosurgical and endovascular coding. The ideal candidate must hold a recognized medical coding certification and demonstrate expertise in coding complex neurosurgical procedures, including but not limited to craniotomies, aneurysm repairs, embolization’s, and spinal surgeries.
JOB DUTIES & RESPONSIBILITIES :
- Accurately assign CPT, ICD-10, and HCPCS codes for endovascular and neurosurgical procedures, ensuring proper reimbursement.
- Review and interpret operative reports, procedure notes, and medical records to assign appropriate codes.
- Ensure compliance with CMS, AMA, and payer-specific regulations regarding coding and billing guidelines.
- Identify and resolve coding discrepancies by collaborating with physicians, clinical staff, and revenue cycle team members.
- Apply National Correct Coding Initiative (NCCI) edits and payer-specific coding guidelines to ensure clean claim submissions.
- Collaborate with neurosurgeons and endovascular specialists to ensure proper documentation supports coding and billing and resolve any documentation discrepancies.
- Provide education to providers on documentation best practices and coding updates to maximize reimbursement and reduce compliance risks.
- Assist in the development and maintenance of coding procedures and training materials.
- Analyze and resolve coding-related denials and rejections by working with the billing and accounts receivable teams.
- Appeal insurance denials with supporting medical documentation and correct coding guidelines.
- Audit and review coding accuracy to minimize denials and optimize reimbursement. Stay current with coding guidelines, regulations, and updates, ensuring continuous compliance with industry standards.
- Participate in the review of claim denials and provide necessary corrections or explanations.
- Maintain coding productivity and accuracy rates as established by the organization.
- Stay up to date with industry coding changes, including CPT, ICD-10, HCPCS, and payer-specific policies, and apply updates accordingly.
- Notifies supervisor of recurring problems regarding office charges.
- Attends staff meetings and participates in special committees as required
- Work closely with the Managers and Directors and clinical staff to resolve any charge-related issues or discrepancies.
- Other duties and assignments as necessary
PERFORMANCE REQUIREMENTS
Communicates well and effectivelyDemonstrates acute awareness of insurance company contractsReports to work regularly without undue tardinessMaintains positive attitude and demonstrates the utmost in professionalismDresses appropriately and professionallyWorks independently, without supervisionCompletes work accurately and in a timely mannerMaintains effective working relationships with physicians, administration and other staff membersTYPICAL PHYSICAL DEMANDS :
Prolonged sitting, standing, some bending, stooping and stretching and / or walkingEye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopier, fax machine, telephone, calculator, and other office equipmentNormal range of hearing and vision to record, prepare, and communicate appropriate reportsTYPICAL WORKING CONDITIONS :
Work is performed in an office environment, with contact with office staff, physicians, etc.Overtime as requiredEDUCATION & EXPERIENCE
High school diploma or GED requiredMust be certified, CPC and other applicable credentials, 2-3 years of coding experience minimum.Proficient with Microsoft Office, Teams, including Outlook and Excel.Requirements :