Surgical Coder

Role Overview

• Review operative reports and clinical documentation to assign appropriate CPT, ICD-10-CM, and HCPCS Level II codes.
• Ensure accurate capture of modifiers and adherence to payer-specific coding guidelines.
• Verify that all coded information supports medical necessity and aligns with regulatory requirements (e.g., CMS, AMA, and payer-specific policies).
• Query physicians for clarification or additional documentation when necessary.
• Maintain current knowledge of coding guidelines, compliance requirements, and regulatory updates.
• Collaborate with billing, compliance, and revenue cycle teams to resolve coding and claim issues.
• Participate in internal audits and quality assurance reviews.
• Meet productivity and accuracy benchmarks as established by the department.
• Protect patient confidentiality in accordance with HIPAA standards.

Requirements

• High school diploma or equivalent required
• Minimum of 3 years of surgical coding experience (ambulatory surgery, hospital outpatient, or inpatient) preferred.
• Certifications (required): Certified Professional Coder (CPC) – AAPC, or Certified Coding Specialist (CCS) – AHIMA, or Certified Outpatient Coder (COC) – AAPC
• Strong knowledge of medical terminology, anatomy, and surgical procedures.
• Proficiency in CPT, ICD-10-CM, and HCPCS Level II coding systems.
• Familiarity with electronic health record (EHR) systems and coding software.
• Excellent analytical, organizational, and communication skills.
• High attention to detail and ability to work independently with minimal supervision.
• Proficiency with EclinicalWorks (eCW) EMHR system preferred.
• Comprehensive understanding of OB/GYN terminology, anatomy and physiology
• Demonstrated experience coding OB global packages, delivers, gynecological surgeries and related procedures.