Optim Health System is seeking (2) full time Surgical Case Reviewer: Certified Coder(s). This is a remote position.
JOB TITLE: Surgical Case Reviewer: Certified Coder
SUPERVISION RECEIVED: Reports directly to Patient Access Director
SUPERVISION EXERCISED: None
TYPICAL WORKING CONDITIONS: Remote
ESSENTIAL DUTIES AND RESPONSIBILITIES: (This list may not include all of the duties assigned.)
· Review all surgical orders submitted for All Optim facilities
o Focusing on Orthopedic, Neuro Spine, Ortho Spine, Sports Medicine, Pain Management
· Orders reviewed for appropriate documentation and coding; feedback given to physicians on any discrepancies
· Medical Necessity reviews according to payer guidelines
· Communication and education with Surgeons and Surgical teams
· Works with Multi-disciplinary teams to ensure codes on order and precertification are accurate and complete
· Ability to stay current on all relevant coding guidelines as well as payer requirements
· Meets or exceeds industry standard production levels and maintains 95% accuracy in quality assurance reviews
· Experience with electronic health records
· Assisting Clinical Revenue with Medical Necessity denials
CERTIFICATE/LICENSE: Certified Professional Coder with three or more years of experience in focus fields listed above.
Surgical Case Reviewer: Certified Coder (F/T) - Remote • Remote, Savannah, GA, US
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