OrthoVirginia, Virginia's largest provider of expert orthopedic and therapy care, is currently seeking a full-time, experienced Coder 1 to join our team! Along with a collaborative, team-oriented work environment, our outstanding employment package includes: competitive salaries, excellent medical, dental, and vision benefits, paid time off (PTO), a generous 401k incentive plan, short-term and long-term disability insurance, life insurance, and a company-wide wellness program.

Position Summary

Review authenticated provider documentation and/or reports to determine if appropriate CPT, ICD codes for billed services is complete and accurate. Must comply with applicable State, Federal and Insurance regulations and guidelines as they apply to codes for consultations; diagnosis; surgical procedures; etc. Assists in resolution of payment denials or independently resolves selected denials.

Responsible to research, analyze and resolve routine pre-bill errors/edits to provider based billing outpatient and surgical billing. Must be able to work independently while prioritizing workflow and produce acceptable volume of work accurately. Can demonstrate good problem-solving skills and the ability to communicate clearly in writing and verbally to providers and support staff.

Notifies appropriate leadership of issues to ensure competency in all aspects of revenue cycle including compliance with applicable regulatory agencies.

Primary Functions and Accountabilities

• Analyze/interpret patient medical records; visit encounters and reports to assign and sequence appropriate codes upon review of the billed information. Ensures that ICD-10, CPT and HCPCS codes accurately reflect the documented record.
• Determines course of action and organizes and prioritizes work.
• Reports coding and documentation trends to appropriate leadership for compliance related concerns.
• May provide price quotes to patients/providers when requested.
• May assist clinic and billing staff with coding related questions
• Works denied charges correctly and in a timely manner
• Seeks advice and guidance from Manager; Physician or other content expert(s) as needed.
• Other duties as assigned

Position Requirements

Minimum requirements High School diploma or equivalent.

One (1) year coding experience including coding review in ICD-10, CPT/HCPCS

AND eligible for eligible for credentials: Certified Procedural Coder (CPC) by American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA) within 12 to 18 months.

Preferred:

• Certification from an accredited Billing and Coding program
• Certified Procedural Coder (CPC) by American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS) or Certified Coding Associate (CCA) by the American Health Information Management Association (AHIMA)
• Two (2) years of healthcare experience including progressive coding or coding review in ICD-10; CPT/HCPCS, with one (1) year's experience coding medical records and/or billing claims experience.

Pre-Employment background check, drug screen and TB test required for all new hires.

OrthoVirginia, Inc. is an Equal Opportunity Employer.

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