Medical Biller/Coder

Medical Biller/Coder

Job Description

CNSO is a vibrant, well-established neurosurgery, spine surgery, orthopedic spine surgery, pain management, and physical therapy practice with multiple office locations throughout Northern New Jersey. Due to continued expansion, CNSO has an exciting opportunity to join its revenue cycle department in its Wayne location.

We are seeking an experienced Medical Biller/Coder with strong surgical coding expertise to accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for neurosurgery, orthopedic spine, pain management, physical therapy, and E/M services. The ideal candidate has in-depth knowledge of CMS guidelines, NCCI edits, and payer policies, and communicates professionally with providers, internal teams, and insurance carriers. This position will serve as a subject matter resource for surgical coding and can work both independently and collaboratively. CNSO provides a two-month orientation and training process, and our highly organized revenue cycle department holds weekly educational meetings.

Essential Duties and Responsibilities

Coding and Documentation Review

• Accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for professional surgical services and other assigned services based on thorough review of provider documentation.
• Evaluate medical records for completeness, accuracy, proper code assignment, and support of medical necessity.
• Apply appropriate modifiers and ensure correct provider, place of service, and payer selection.
• Identify and correct undercoding, overcoding, modifier misuse, and unbundling issues, and update coding on claims requiring correction.
• Collaborate with providers and operational leadership to clarify documentation and improve coding specificity.

Compliance and Quality

• Ensure coding complies with CMS guidelines, NCCI edits, commercial payer policies, regulatory requirements, and internal standards.
• Conduct pre-submission claim review, including billing edits and clearinghouse rejections related to coding, to support clean claim submission and reduce denials.
• Analyze coding-related denials and recommend corrective actions.
• Audit coding accuracy through ad hoc reports, focused reviews, and special projects.
• Stay current on annual coding updates, regulatory changes, and payer-specific coding and reimbursement policies.

Performance and Team Contribution

• Meet productivity and quality benchmarks established by the Revenue Cycle Director.
• Serve as a subject matter resource for surgical coding guidance within assigned service lines.
• Participate in weekly departmental educational meetings.
• Other coding-related duties as assigned.

Qualifications:

Experience/Training/Education:

Knowledge, Skills, and Abilities

• High-level knowledge of surgical medical terminology, anatomy, and pathophysiology, particularly as related to neurosurgery and the spine.
• Strong understanding of CPT procedure coding, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis coding.
• Strong understanding of CMS guidelines, NCCI edits, bundling rules, and insurance reimbursement policies.
• Ability to evaluate documentation for medical necessity and coding compliance.
• Proficiency with EHR and practice management systems, clearinghouses, claim scrubber tools, and coding resources such as Codify and CMS policy lookup tools.
• Advanced analytical and problem-solving skills, with a high level of attention to detail and accuracy.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities, meet deadlines, and work both independently and collaboratively within a structured team.
• Proficiency in Microsoft Office applications.

Ability to maintain confidentiality and exercise professional discretion

Education and Experience

• High school diploma or equivalent required
• Minimum of five (5) years of professional medical coding experience, including strong surgical coding experience.
• Active coding certification required through the American Academy of Professional Coders (AAPC), e.g., CPC, or the American Health Information Management Association (AHIMA), e.g.,CCS.
• Experience coding in surgical practices, ambulatory surgery centers, or hospital settings required; specialty experience in neurosurgery, spine, pain management, or physical therapy strongly preferred.

Benefits:

• Medical Benefits
• Dental and Vision Plan
• PTO
• 401K

·Work Location:

• One location-Wayne. NJ
• Work Remotely, No
• Job Type: Full-time

Job Type: Full-time

Pay: $30.00 - $35.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Ability to Commute:

• Wayne, NJ 07470 (Required)

Ability to Relocate:

• Wayne, NJ 07470: Relocate before starting work (Preferred)

Work Location: In person

Salary : $30 - $35