Orthopedic Fracture Specialist and Center for Speciality Surgery are collectively seeing a Certified Medical Coder (CMC). The CMC is responsible for coding of office based visits and procedures, procedures performed at the ambulatory surgery center, and procedures performed at local area hospitals. In addition, the CMC also reviews prior authorizations for accuracy, providing expertise in guiding denials and appeals, and answers questions from staff, physicians, and APPs regarding coding. The CMC is also responsible for ensuring that all services have been billed and may work denials and appeals personally. They serve as the organization’s expert in changes to ICD10 codes, CPT codes, and HCPCS codes along with various payer rules and regulations, NCCI edits/bundles, and coding trends.

This role performs all duties in a manner which promotes team concept and reflects Orthopedic Fracture Specialists mission and philosophy.

KEY RELATIONSHIPS: Between, physicians, O F staff, clinic customers and payers.

EDUCATION, CERTIFICATION, TRAINING AND EXPERIENCE:

1. CPC or CMC certifications required

2. Minimum two years' experience working in a healthcare environment preferred

3. Two years' experience working as a medical coder preferred

4. Two years' experience working in orthopedics preferred

KNOWLEDGE, SKILLS AND ABILITIES:

1. Strong interpersonal skills.

2. Effective written and oral communications.

3. Strong ability to triage, prioritize, and work in a fast-paced environment.

4. Willingness and desire to work as part of a team.

5. Excellent computer skills.

6. Ability to work independently.

7. Excellent documentation skills and habits.

STANDARD OF PERFORMANCE:

1. Actively supports and incorporates mission into daily activities as outlined in the Clinic Mission Statement.

2. Demonstrates a positive attitude and positive interactions with public, employees, physicians, and administration so that productivity and positive interpersonal relationships are maximized.

3. Maintains confidentiality of all patient-related information.

4. Adheres to established policies and procedures.

5. Is polite and team oriented.

KEY RESPONSIBILITIES:

1. Review medical records for accuracy and completion.

2. Coding and billing charges, including troubleshooting failed submissions.

3. Follow up on missing, lost, or incomplete documentation.

4. Provide education to staff and providers.

5. Answer questions from other departments related to coding, denials, and appeals.

6. Monitor the status of all fee tickets to ensure that all charges are submitted in a timely fashion.

7. Research denied claims to identify areas of improvement from both a process and documentation standpoint.

8. Identify patterns/trends in denials and provide feedback/recommendations on how to avoid denials.

9. Identify opportunities to improve revenue, including analysis of common denial codes to assist management in building custom scrubber edits based on payer and/or code.

10. Keep updated on coding changes and inform leadership.

11. Review procedure prior authorizations.

12. Code and bill office-based, hospital, and ASC charges. This includes physician and facility portions.

13. Ensure that all charges from unscheduled services, such as physician on-call services, are identified, documented, and billed.

14. Conduct internal audits and report on findings.

MAJOR CHALLENGES:

1. Working at a fast pace while maintaining accuracy, flexibility, and a positive attitude.

2. Accomplishing all of the above with physician, patient satisfaction, and staff relations in mind.

*** As a member of the O F team, you may be asked to assist whenever and wherever there is a need. This may include providing coverage for fellow employees in the event of an illness or other time off. ***

Job Type: Full-time

Pay: $24.00 - $30.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off

Work setting:

• Hybrid work

Work Location: Hybrid remote in Portland, OR 97225