Banner Health · 1 day ago
Profee Complex Coder Orthopedic
United States
Full-time
Remote
Mid, Senior Level
$25.54/hr - $38.30/hr
3+ years expBanner Health is a nationally-recognized healthcare leader seeking a motivated, experienced Orthopedic Physician Complex Coder to join their talented Profee team. This role focuses on coding surgeries and hospital E&M coding while ensuring compliance with national coding guidelines and appropriate reimbursement requirements.
Health CareInsuranceNon Profit
Responsibilities
Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required
Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment
Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards
As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes
Able to identify validation edits and revision issues to ensure compliant coding
Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance
Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations)
Qualification
Required
Minimum 3 years recent experience in Surgical Orthopedic Profee coding (clearly reflected in your attached resume)
Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. Please note, this is a COMPLEX role, requiring more than a CPC-A level certification
High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate's degree in a related health care field
Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist – Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty
Requires three or more years of complex professional coding experience within specialty
Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems
Preferred
COSC Certification a plus
Specialty Certification. Radiology Certified Coder (RCC) if employed in the Imaging space
Experience In a Large, Multi-system Physician Practice Preferred
Additional related education and/or experience preferred
Company
Banner Health
Banner Health operates as a nonprofit health care system in the United States. The company offers hospital care, home care, hospice care,
10001+ employees
H1B Sponsorship
Banner Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (85)
2024 (70)
2023 (35)
2022 (47)
2021 (51)
2020 (29)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Diane and Bruce Halle Foundation
2025-10-24Grant
Leadership Team
Andy Kramer Petersen
President & CEO Banner Health Foundation
Brian P. Kellar
Chief Executive Officer
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