Certified Professional Coder - Ophthalmology

Job Summary:

We are seeking a detail-oriented and experienced Certified Professional Coder (CPC) to specialize in ophthalmology and optometry encounters. The successful candidate will be responsible for accurately reviewing, analyzing, and coding medical documentation to ensure proper billing, compliance with federal and state regulations, and efficient revenue cycle management. This role requires a strong understanding of CPT, ICD-10-CM, and HCPCS codes specific to eye care procedures and diagnoses.Essential Duties and Responsibilities

• Review encounters to assure appropriate CPT, ICD-10-CM, and HCPCS codes have been applied to patient encounters and surgical procedures based on medical record documentation.
• Ensure all coding practices comply with federal, state, and payer-specific requirements, including Medicare and Medicaid guidelines.
• Collaborate with physicians, clinical staff, and the billing team to clarify diagnoses, procedures, and documentation when necessary to ensure accurate coding.
• Work to resolve coding-related claim rejections and denials in a timely manner.
• Perform scheduled audits of physician documentation and coding, providing feedback and education for documentation improvement.
• Maintain up-to-date knowledge of coding regulations, compliance guidelines, and changes within the ophthalmology specialty.
• Protect the confidentiality of patient medical records in compliance with HIPAA and other relevant regulations.
• Assist with special projects and reporting related to coding and revenue cycle performance as needed.

Qualifications and Skills

Required:

• High school diploma or equivalent.
• Current and active medical coding certification (e.g., CPC (Certified Professional Coder) from AAPC, CCS-P (Certified Coding Specialist – Physician-based) from AHIMA, or an ophthalmology-specific certification like OCS (Ophthalmic Coding Specialist) from the American Academy of Ophthalmology).
• Minimum of 2 years of experience in medical coding, preferably in a multi-specialty or ophthalmology-specific setting.
• Proficient knowledge of medical terminology, anatomy, and physiology specific to ophthalmology.
• Strong attention to detail, analytical problem-solving skills, and the ability to work independently or as part of a team.
• Familiarity with electronic health record (EHR) systems and medical billing software (experience with Epic is a plus).
• Excellent written and verbal communication skills for effective collaboration with providers and staff.

Preferred:

• Experience coding complex ophthalmology surgeries, eye corrections, and diagnostic radiology related to eye care.
• Experience in a high-volume clinical environment.
• Additional certifications such as Certified Ophthalmic Assistant (COA) or Certified Ophthalmic Technician (COT).

Job Type: Full-time

Pay: $16.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• Flexible spending account
• Health insurance
• Paid time off
• Retirement plan

Work Location: In person

Salary : $16 - $25