• The Surgical Coder for Spine is responsible for accurate and compliant coding of complex orthopedic spine procedures across all care settings. • Code high-complexity spine procedures (e.g., fusions, decompressions, instrumentation, revisions). • Verify all documentation is complete and compliant. • Assign codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. • Follow coding conventions and ensure accurate assignment of CPT (including add-on codes, modifiers, bundling rules). • Validate levels, laterality, approach (anterior/posterior). • Identify missed billable components (e.g., additional levels, hardware, biologics). • Query provider for any necessary clarification related to unclear, unspecified or missing/incomplete documentation. • Apply payer-specific coding rules and edits. • Research, analyze, recommend, and facilitate a plan of action to correct discrepancies and prevent future coding errors.

• Perform diagnosis coding of inpatient, outpatient, and physician office medical records • Record all process information in system in accordance with contract and organizational guidelines • Review feedback from Senior Coders to improve accuracy and quality of work • Maintain security and confidentiality of medical records and Protected Health Information (PHI)

• Perform diagnosis coding of inpatient, outpatient, and physician office medical records per Risk Adjustment/Medicare Part C guidelines. • Perform intake validity checks on each medical record submitted. • Perform Medical Record Dispute and Appeal reviews. • Provide Appeals support as RADV Subject Matter Expert at CMS request. • Participate and contribute to QA Panel discussions for medical record review intake/coding and appeals. • Interact with the physician reviewer(s) as required. • Accurately enter data into encoder, system, and other as required software using a personal computer, keyboard and/or mouse. • Consistently meet or exceed productivity and accuracy standards of 95% minimum IRR established by the customer and/or the company.

• Manage incoming and outgoing payments for medical treatment. • Communicate with clients about their outstanding balance and handle the administrative responsibilities of billing insurance and processing payments. • Checking clients’ eligibility and coverage on a daily basis. (Online & through call if necessary) • Review and resolve the to-do list daily. • Accept inbound calls. • Always document the conversation to Billing Comments of Therapy Notes. • Calling clients to collect aging balances. • Resolve claims denial. • Contracting and credentialing knowledge. • Other billing-related work.