Job Title:
Multispecialty Surgery Coding – SME (Professional & Facility)
Job Summary:
We are seeking an experienced Multispecialty Surgery Coding Expert to serve as a Subject Matter Expert (SME) for both professional and facility surgery coding. The SME will provide in-depth knowledge, training, auditing, and guidance on complex surgical coding across multiple specialties, ensuring compliance with ICD-10-CM, CPT, HCPCS, CMS guidelines.
Key Responsibilities:
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Serve as the go-to resource for multispecialty surgical coding questions (professional and facility).
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Perform accurate coding for complex surgical procedures across multiple specialties, including orthopedic, cardiovascular, neurological, digestive, urology, general surgery, IVR and transplant cases.
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Review operative reports, anesthesia notes, and other clinical documentation to ensure correct code assignment.
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Provide training, mentoring, and support to coders and auditors on complex surgical scenarios.
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Conduct audits, root cause analysis, and compliance reviews to identify coding/documentation gaps.
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Stay updated on official coding guidelines (CMS, AHA Coding Clinic, CPT Assistant, OIG, and payer-specific policies).
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Develop best practices, SOPs, and workflow improvements for professional and facility surgery coding.
Qualifications & Skills:
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Certification: CPC, CCS, CIC, or COC required (CCDS or CCDS-O preferred).
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Experience: Minimum 5+ years of multispecialty professional and facility coding experience, with a strong focus on surgical coding.
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Excellent knowledge of NCCI edits, modifiers, and payer-specific guidelines.
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Prior experience as an SME, trainer, or auditor in coding operations preferred.
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Strong analytical, problem-solving, and communication skills.
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Proficiency in 3M , Optum, Encoder, or other leading HIM/coding applications.
