Experienced Orthopedic Surgical Auditor or Coder

For over 30 years, Welter Healthcare Partners has collaborated with healthcare organizations across the US on the business of healthcare. Healthcare is complicated and ever-changing, and our services, solutions, highly specialized and collaborative teams are focused on helping drive results for the long-term success of our clients! We are looking for new team members that share the same passion for success!

 We are looking for a 1099 Surgical Coding Expert, primarily Orthopedics, who seeks ownership of their craft, asserts their interpretation of guidelines and rules and who is extremely particular about the highest level of quality of their coding work! Skilled auditor preferred; however, a skilled and detail-oriented coder with the desire to transition to auditing will be highly considered.

 We offer up to $4,000 flat fee per month and are flexible for more depending on the ability to organize and facilitate volume, but quality over quantity. Opportunity incentivized by completion of audits with the ability to defend CPT, ICD-10-CM & CMS rules and guidelines; and education summaries for providers or detailed education summaries for coders.

 About the Role

We are seeking highly experienced Orthopedic Medical Auditor and/or a highly skilled coder ready to take it to the next level in auditing. Must have current expertise in orthopedic coding to support a dynamic MSO organization with multiple clients. This role requires coders who are actively coding or auditing orthopedics on a regular basis.

The ideal candidate will be fully up to date on current orthopedic coding guidelines and comfortable providing coding feedback and education to orthopedic providers, particularly regarding bundling/unbundling rules, modifier usage, and coding compliance.

 Key Responsibilities

 Client Technical Support - there are times when clients need support outside of the audit program, not limited to:

• Client charge review work queues assistance, answers provider or coder inquiries in a timely fashion, reviews post-bill denials and payer edits analyze documentation and recommend coding updates to resolve issues, etc
• Audits performed in automated audit tool and some in manual excel spreadsheet.
• Analyzes samples of cases that have been billed to payer or patient, reviews this provider-or coder submitted coding against clinical documentation for accuracy, correction and guidelines applied errors.
• Recommends coding corrections to RCM departments and prepares the Post Audit Education/training documents.
• Recommends appropriate coding corrections based on documentation.

Additional responsibilities include:

• Reviewing documentation to ensure coding accuracy and compliance
• As requested by client, but not always, review coding edits, denials, and payer requirements
• Providing coding guidance and feedback to orthopedic providers and departments

Requirements:

• Minimum 5 years of active, ongoing orthopedic coding experience
• Current CPC (AAPC) or equivalent certification through AAPC or AHIMA
• Extensive experience coding orthopedic services in POS 11, 21, and 22
• Experience coding in-office procedures and orthopedic surgeries
• Strong knowledge of billing edits, clearinghouse edits, and payer denials
• Comfortable providing coding feedback and education to providers. If not comfortable with provider facing education, have the willingness to prepare the education in good detail for the educators.

Preferred Qualifications:

• CPC or CCS certification, additional specialty certifications highly desired
• Orthopedic Coding Expertise Required
• Experience with multiple EHRs
• Multi-specialty coding background

Candidates must demonstrate strong experience coding in head-to-toe ortho surgery, OR, ASC and in-office procedures, not limited to:

• Spinal injections / pain management procedures
• Spine surgery
• Open fracture repair
• Hand surgery, fracture care, and tendon repairs
• Carpal tunnel release
• Hardware removal procedures
• Neuroplasty
• Arthroscopy (shoulder, knee, hip)
• Arthroplasty (shoulder, knee, hip)
• Joint repairs

Laptop and Equipment supplied

Work Location: Remote