Surgery Medical Coder II

Job Description

Job Description

Description:

JOB TITLE : Surgery Medical Coder II

DEPARTMENT : Business Office

REPORTS TO : Coding Manager and Director of Revenue Cycle

FLSA STATUS : Hourly

JOB SUMMARY : The Surgery Medical Coder is responsible for all Endovascular & Neurosurgery coding, accurately assigning CPT,

ICD-10, and HCPCS codes for professional services rendered by neurosurgeons, ensuring proper documentation and compliance with federal, state, and payer-specific guidelines. This role requires a highly skilled and detail-oriented individual with at least 2-3 years of experience in neurosurgical and endovascular coding. The ideal candidate must hold a recognized medical coding certification and demonstrate expertise in coding complex neurosurgical procedures, including but not limited to craniotomies, aneurysm repairs, embolization’s, and spinal surgeries.

JOB DUTIES & RESPONSIBILITIES:

· Accurately assign CPT, ICD-10, and HCPCS codes for endovascular and neurosurgical procedures, ensuring proper reimbursement.

· Review and interpret operative reports, procedure notes, and medical records to assign appropriate codes.

· Ensure compliance with CMS, AMA, and payer-specific regulations regarding coding and billing guidelines.

· Identify and resolve coding discrepancies by collaborating with physicians, clinical staff, and revenue cycle team members.

· Apply National Correct Coding Initiative (NCCI) edits and payer-specific coding guidelines to ensure clean claim submissions.

· Collaborate with neurosurgeons and endovascular specialists to ensure proper documentation supports coding and billing and resolve any documentation discrepancies.

· Provide education to providers on documentation best practices and coding updates to maximize reimbursement and reduce compliance risks.

· Assist in the development and maintenance of coding procedures and training materials.

· Analyze and resolve coding-related denials and rejections by working with the billing and accounts receivable teams.

· Appeal insurance denials with supporting medical documentation and correct coding guidelines.

· Audit and review coding accuracy to minimize denials and optimize reimbursement. Stay current with coding guidelines, regulations, and updates, ensuring continuous compliance with industry standards.

· Participate in the review of claim denials and provide necessary corrections or explanations.

· Maintain coding productivity and accuracy rates as established by the organization.

· Stay up to date with industry coding changes, including CPT, ICD-10, HCPCS, and payer-specific policies, and apply updates accordingly.

· Notifies supervisor of recurring problems regarding office charges.

· Attends staff meetings and participates in special committees as required

· Work closely with the Managers and Directors and clinical staff to resolve any charge-related issues or discrepancies.

· Other duties and assignments as necessary

PERFORMANCE REQUIREMENTS

· Communicates well and effectively

· Demonstrates acute awareness of insurance company contracts

· Reports to work regularly without undue tardiness

· Maintains positive attitude and demonstrates the utmost in professionalism

· Dresses appropriately and professionally

· Works independently, without supervision

· Completes work accurately and in a timely manner

· Maintains effective working relationships with physicians, administration and other staff members

TYPICAL PHYSICAL DEMANDS :

• Prolonged sitting, standing, some bending, stooping and stretching and/or walking
• Eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopier, fax machine, telephone, calculator, and other office equipment
• Normal range of hearing and vision to record, prepare, and communicate appropriate reports

TYPICAL WORKING CONDITIONS :

• Work is performed in an office environment, with contact with office staff, physicians, etc.
• Overtime as required

EDUCATION & EXPERIENCE

· High school diploma or GED required

· Must be certified, CPC and other applicable credentials, 5 years of coding experience minimum.

· Proficient with Microsoft Office, Teams, including Outlook and Excel.

Requirements: