Surgical Billing Coder (Spine and General Orthopedic) Spine and Sports Specialties Medical Group 1120 West La Veta Avenue, Orange, CA 92868

Job Summary:

We are seeking a detail-oriented and experienced Surgical Billing Coder to join our team. This role will specialize in coding for spine and general orthopedic procedures, ensuring accurate and timely billing for surgeries, outpatient visits, and other related services. The ideal candidate will have in-depth knowledge of orthopedic and spine surgical codes, including ICD-10, CPT, and HCPCS, and will be proficient in working with insurance companies to resolve claims and ensure accurate reimbursement.

Key Responsibilities:

Coding & Billing:

Accurately assign and apply ICD-10, CPT, and HCPCS codes to spine and orthopedic surgical procedures, as well as other related services such as pain management services.

Procedure Documentation Review:

Thoroughly review patient medical records, surgical reports, and physician notes to ensure all procedures are documented correctly for coding purposes.

Insurance Claims:

Prepare and submit insurance claims for spine and orthopedic surgeries to ensure proper reimbursement. Communicate with insurance companies to resolve issues such as denials or discrepancies.

Compliance & Regulations:

Ensure all coding and billing practices comply with current healthcare regulations, including CMS, HIPAA, and other federal and state guidelines. Stay current with changes to coding practices, payer policies, and industry standards.

Audit & Quality Control:

Participate in internal audits to ensure coding accuracy and to identify opportunities for process improvement. Work with physicians and clinical staff to clarify any discrepancies or unclear documentation.

Patient Billing & Queries:

Assist with patient billing inquiries related to spine and orthopedic procedures, ensuring that patients are provided with accurate, understandable, and timely billing statements.

Cross-functional Collaboration:

Work closely with the surgical team, clinical staff, and administrative personnel to ensure proper coding and billing protocols are followed. Provide guidance to physicians on appropriate coding and documentation.

Qualifications:

Education:

High school diploma or equivalent (required); Associate's or Bachelor's degree in Health Information Management, Medical Billing, or a related field (preferred).

Certification:

Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) from a recognized credentialing organization such as AAPC or AHIMA (preferred).

Experience:

At least 2-3 years of experience in medical coding, with a focus on orthopedic and spine surgery coding.

Skills & Knowledge:

Proficiency in ICD-10, CPT, and HCPCS coding systems. In-depth knowledge of orthopedic and spine surgical procedures and associated coding. Strong understanding of insurance billing and reimbursement processes, including Medicare, Medicaid, and private payers. Familiarity with coding and billing software (e.g., Epic, 3M, NextGen). Excellent attention to detail and problem-solving skills. Strong communication skills, both verbal and written, with the ability to interact with physicians, insurance companies, and patients.

Preferred Qualifications:

Experience with electronic health records (EHR) and practice management software. Knowledge of orthopedic and spine surgical terminology and anatomy. Previous experience working with spine surgery, including procedures such as spinal fusion, laminectomy, discectomy, and other complex spine surgeries.

Working Conditions:

Full-time, with standard business hours (Monday-Friday). Opportunity for remote work, depending on company policy. Collaborative, team-oriented environment within a healthcare setting.

Compensation & Benefits:

Competitive salary based on experience. Health, dental, and vision insurance. Retirement plan with employer contributions. Paid time off (PTO), sick leave, and holiday pay. Continuing education support and certification reimbursement. Data Entry/ Billing Must have 3 years previous experience in Orthopedics and Pain Mgmt billing / procedure billing. Full knowledge of CPT and ICD-10 coding Posting charges for Pain Management and Orthopedic Mist be familiar with Medicare billing/coding. Salary based on experience with excellent benefits. Based on previous experience. Competitive benefit package available. Please attach Resume when submitting your response.

Job Type:

Full-time Pay:

$27.00 - $30.00 per hour Expected hours: 30 per week Ability to

Relocate:

Orange, CA 92868: Relocate before starting work (Required)

Work Location:

In person