Job Description
Job DescriptionDescription:
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 effectively
· Demonstrates acute awareness of insurance company contracts
· Reports to work regularly without undue tardiness
· Maintains positive attitude and demonstrates the utmost in professionalism
· Dresses appropriately and professionally
· Works independently, without supervision
· Completes work accurately and in a timely manner
· Maintains effective working relationships with physicians, administration and other staff members
TYPICAL PHYSICAL DEMANDS:
- Prolonged sitting, standing, some bending, stooping and stretching and/or walking
- Eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopier, fax machine, telephone, calculator, and other office equipment
- Normal range of hearing and vision to record, prepare, and communicate appropriate reports
TYPICAL WORKING CONDITIONS:
- Work is performed in an office environment, with contact with office staff, physicians, etc.
- Overtime as required
EDUCATION & EXPERIENCE
· High school diploma or GED required
· Must be certified, CPC and other applicable credentials, 2-3 years of coding experience minimum.
· Proficient with Microsoft Office, Teams, including Outlook and Excel.
Requirements: