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:
- Serve as the go-to resource for multispecialty surgical coding questions (professional and facility).
- Perform accurate coding for complex surgical procedures across multiple specialties, including orthopedic, cardiovascular, neurological, digestive, urology, general surgery, IVR and transplant cases.
- Review operative reports, anesthesia notes, and other clinical documentation to ensure correct code assignment.
- Provide training, mentoring, and support to coders and auditors on complex surgical scenarios.
- Conduct audits, root cause analysis, and compliance reviews to identify coding/documentation gaps.
- Stay updated on official coding guidelines (CMS, AHA Coding Clinic, CPT Assistant, OIG, and payer-specific policies).
- Develop best practices, SOPs, and workflow improvements for professional and facility surgery coding.
Qualifications & Skills:
- Certification: CPC, CCS, CIC, or COC required (CCDS or CCDS-O preferred).
- Experience: Minimum 6+ years of multispecialty professional and facility coding experience, with a strong focus on surgical coding.
- Excellent knowledge of NCCI edits, modifiers, and payer-specific guidelines.
- Prior experience as an SME, trainer, or auditor in coding operations preferred.
- Strong analytical, problem-solving, and communication skills.
- Proficiency in 3M , Optum, Encoder, or other leading HIM/coding applications.
