Tidelands Health
Provider Coding Specialist- Orthopedic
Tidelands Health, Columbia, South Carolina, United States
Provider Coding Specialist
Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As the region's largest health‑care provider and one of the area's largest employers, we are proud to have over 2,500 team members across more than 70 locations delivering health care to our community.
A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist analyzes and assigns ICD‑10‑CM diagnostic codes, CPT and HCPCS codes to professional surgical patient accounts based on the medical information provided. The role follows regulatory guidance, best practices, and Organization policy and procedure, and abides by the Standards of Ethical Coding set forth by AHIMA and AAPC. Responsibilities include abstracting clinical information, querying physicians to clarify documentation, organizing work to meet deadlines, maintaining and expanding coding knowledge, and resolving coding edits, account checks, rejections, and denials to ensure accurate reimbursement and a clean claim rate.
What You Will Do
Analyze medical records, interpret documentation, and assign proper ICD‑10‑CM, CPT/HCPCS, and modifiers using designated software, coding manuals, and reference material.
Enter charges for procedures that are not soft‑coded as instructed for certain patient types.
Consistently meet coding quality and productivity standards established by the coding department.
Work closely with Patient Financial Service (PFS) to review documentation and act as a department expert on coding questions.
Gather and verify all information required to produce a clean claim, including special billing procedures defined by a payer or contract.
Review and resolve clearinghouse rejection errors, denials, and charge review/claim edits daily; process corrections for clean claim submission.
Collaborate with the Compliance/Quality Team to implement coding quality recommendations.
Work with HIM operations to clarify queries and documentation needs for medical record completion.
Review and code orthopedic, OB/GYN, and other surgical specialty procedures with minimal supervision, ensuring correct coding and sequencing.
Provide continuous education and feedback to surgeons and clinical staff regarding ICD‑10 coding and documentation best practices for surgical procedures.
Education Qualifications
High School Diploma Required
Experience Qualifications
2+ years of abstract coding for physician services Required
Minimum of four years of healthcare experience, with at least three years of professional coding experience in Orthopedics or OB/GYN Required
Experience working remotely Preferred
Skills and Abilities
Basic knowledge of ICD‑10‑CM diagnostic and CPT/HCPCS procedure code principles and guidelines.
Basic knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and metric systems.
Basic knowledge of Standards of Ethical Coding.
Effective oral and written communication.
Ability to maintain working relationships with physicians and other staff.
Ability to review work of others and maintain confidentiality.
Proficiency in Microsoft Applications (Excel, Word, PowerPoint, Outlook).
Strong analytical and organizational skills.
Advanced ability to work independently and be a self‑starter.
Outstanding research skills and independent judgment for problem solving.
Handles multiple priorities and listens attentively to ideas and expressions.
Communicates clearly using appropriate verbal and body language.
Collaborates to achieve common goals and influence others for positive outcomes.
Expertise in accurate CPT®, HCPCS Level II, and ICD‑10‑CM medical code assignment based on payer guidelines.
Maintains solid understanding of anatomy, physiology, and medical terminology for accurate coding.
Licenses and Certifications
Registered Health Information Administrator – AHIMA Required
Registered Health Information Technician – AHIMA Required
Certified Coding Specialist – AHIMA Required
Certified Coding Specialist – Physician‑based – AHIMA Required
Certified Coding Associate – AHIMA Required
Physical Demand Light Physical Demand
Equal Opportunity Statement Tidelands Health is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Tidelands Health is an equal opportunity employer (EOE) and does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
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A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist analyzes and assigns ICD‑10‑CM diagnostic codes, CPT and HCPCS codes to professional surgical patient accounts based on the medical information provided. The role follows regulatory guidance, best practices, and Organization policy and procedure, and abides by the Standards of Ethical Coding set forth by AHIMA and AAPC. Responsibilities include abstracting clinical information, querying physicians to clarify documentation, organizing work to meet deadlines, maintaining and expanding coding knowledge, and resolving coding edits, account checks, rejections, and denials to ensure accurate reimbursement and a clean claim rate.
What You Will Do
Analyze medical records, interpret documentation, and assign proper ICD‑10‑CM, CPT/HCPCS, and modifiers using designated software, coding manuals, and reference material.
Enter charges for procedures that are not soft‑coded as instructed for certain patient types.
Consistently meet coding quality and productivity standards established by the coding department.
Work closely with Patient Financial Service (PFS) to review documentation and act as a department expert on coding questions.
Gather and verify all information required to produce a clean claim, including special billing procedures defined by a payer or contract.
Review and resolve clearinghouse rejection errors, denials, and charge review/claim edits daily; process corrections for clean claim submission.
Collaborate with the Compliance/Quality Team to implement coding quality recommendations.
Work with HIM operations to clarify queries and documentation needs for medical record completion.
Review and code orthopedic, OB/GYN, and other surgical specialty procedures with minimal supervision, ensuring correct coding and sequencing.
Provide continuous education and feedback to surgeons and clinical staff regarding ICD‑10 coding and documentation best practices for surgical procedures.
Education Qualifications
High School Diploma Required
Experience Qualifications
2+ years of abstract coding for physician services Required
Minimum of four years of healthcare experience, with at least three years of professional coding experience in Orthopedics or OB/GYN Required
Experience working remotely Preferred
Skills and Abilities
Basic knowledge of ICD‑10‑CM diagnostic and CPT/HCPCS procedure code principles and guidelines.
Basic knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and metric systems.
Basic knowledge of Standards of Ethical Coding.
Effective oral and written communication.
Ability to maintain working relationships with physicians and other staff.
Ability to review work of others and maintain confidentiality.
Proficiency in Microsoft Applications (Excel, Word, PowerPoint, Outlook).
Strong analytical and organizational skills.
Advanced ability to work independently and be a self‑starter.
Outstanding research skills and independent judgment for problem solving.
Handles multiple priorities and listens attentively to ideas and expressions.
Communicates clearly using appropriate verbal and body language.
Collaborates to achieve common goals and influence others for positive outcomes.
Expertise in accurate CPT®, HCPCS Level II, and ICD‑10‑CM medical code assignment based on payer guidelines.
Maintains solid understanding of anatomy, physiology, and medical terminology for accurate coding.
Licenses and Certifications
Registered Health Information Administrator – AHIMA Required
Registered Health Information Technician – AHIMA Required
Certified Coding Specialist – AHIMA Required
Certified Coding Specialist – Physician‑based – AHIMA Required
Certified Coding Associate – AHIMA Required
Physical Demand Light Physical Demand
Equal Opportunity Statement Tidelands Health is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Tidelands Health is an equal opportunity employer (EOE) and does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.
Seniority level Mid‑Senior level
Employment type Full‑time
Job function Health Care Provider
Industries Hospitals and Health Care
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