Coding Specialist, Orthopedics Part Time

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

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• The Orthopedic Coding Specialist is responsible for reviewing clinical documentation to accurately identify and assign diagnosis and procedure codes specific to orthopedic services. This role ensures that all encounters are coded in compliance with current CMS, CPT, and ICD-10-CM guidelines, with appropriate use of modifiers relevant to musculoskeletal procedures. The specialist must be able to recognize and communicate documentation deficiencies, ensuring coding is complete, accurate, and compliant. Collaboration with providers and coding leadership is essential to maintain high standards of quality and integrity in orthopedic coding.

• Perform ongoing analysis of orthopedic medical record documentation and assigned codes in accordance with CMS, CPT, ICD-10-CM, and Ventra Health documentation guidelines.
• Assign accurate ICD-10-CM and CPT codes specific to orthopedic procedures (e.g., joint injections, fracture care, arthroscopies, spinal surgeries) and apply appropriate modifiers (e.g., -RT, -LT, -59, -XU).
• Conduct MIPS reviews with a focus on orthopedic quality measures and performance metrics.
• Perform Provider QA for orthopedic documentation and coding accuracy.
• Identify and document coding errors, especially those related to musculoskeletal diagnoses and procedures.
• Audit orthopedic charts at an average rate of 10–15 charts per hour, ensuring compliance and accuracy.
• Support coding management with ortho-specific insights and recommendations.
• Assist with client/provider audits, particularly those involving orthopedic practices or surgical centers.
• Review work product of new orthopedic coders in training, providing guidance on musculoskeletal coding standards.
• Provide feedback to coders on discrepancies in orthopedic coding and documentation.
• Alert coding manager to documentation deficiencies related to orthopedic procedures in a timely manner.
• Respond to coding questions from designated orthopedic coders.
• Maintain confidentiality of all personal, financial, and medical information per HIPAA and Ventra Health policy.

• High school diploma or equivalent.
• RHIT and/or CPC certification or equivalent required.
• 1–2 years of experience in medical coding, with orthopedic coding experience strongly preferred.

• Deep understanding of CPT coding for orthopedic procedures, including surgical and non-surgical treatments.
• Proficient in ICD-10-CM coding for musculoskeletal conditions (e.g., osteoarthritis, fractures, tendon injuries).
• Strong grasp of modifier usage in orthopedic coding (e.g., bilateral procedures, staged surgeries).
• Ability to interpret orthopedic documentation and assign accurate codes for diagnosis and procedures.
• Familiarity with state/federal regulations and payer-specific guidelines for orthopedic services.
• Flexible and collaborative in a fast-paced orthopedic coding environment.
• Professional communication skills with providers, coders, and auditors.
• Knowledge of orthopedic medical terminology and anatomy (e.g., joints, bones, ligaments).
• Strong organizational and time management skills.
• Basic proficiency in Microsoft Outlook, Word, Excel, and billing software (with proficiency expected within 4 weeks).

Equal Employment Opportunity (Applicable only in the US)
Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.
 
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