Orthopedic Claim Scrubber & Medical Coder

Role Overview We are seeking a highly skilled Orthopedic Medical Coder and Claim Scrubber with direct EPIC EHR experience to join our growing revenue cycle team. This role is critical for ensuring clean claim submissions, maintaining coding compliance, and maximizing reimbursement for complex orthopedic procedures. You will play a central role in preventing denials and optimizing revenue through detailed review and collaboration with clinical and billing teams. Key Responsibilities Comprehensive Claim Scrubbing: Review all orthopedic claims for accuracy, completeness, and compliance prior to submission. Specialized Orthopedic Coding: Assign precise CPT, ICD-10, and HCPCS codes for both surgical and clinical orthopedic services, including joint replacements, fracture care, arthroscopies, and sports medicine procedures. EPIC EHR Expertise: Utilize EPIC’s coding and claim processing modules to ensure efficient workflow and documentation accuracy. Compliance & Guidelines: Ensure all claims adhere to payer-specific, federal, and orthopedic coding regulations. Documentation Collaboration: Work with physicians and clinical staff to resolve documentation gaps or discrepancies. Denial Prevention & Analysis: Identify patterns in claim denials specific to orthopedic coding and recommend corrective measures. Continuous Learning: Stay current with orthopedic coding updates, payer policy changes, and new procedural coding requirements.