Coding Specialist, Orthopedics

About Us: Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. - Come Join Our Team - As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards. - Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus Job Summary: - The Orthopedic Coding Specialist is responsible for reviewing clinical documentation to accurately identify and assign diagnosis and procedure codes specific to orthopedic services. This role ensures that all encounters are coded in compliance with current CMS, CPT, and ICD-10-CM guidelines, with appropriate use of modifiers relevant to musculoskeletal procedures. The specialist must be able to recognize and communicate documentation deficiencies, ensuring coding is complete, accurate, and compliant. Collaboration with providers and coding leadership is essential to maintain high standards of quality and integrity in orthopedic coding. - This position is remote for candidates located in Chennai. Essential Functions and Tasks: - Perform ongoing analysis of orthopedic medical record documentation and assigned codes in accordance with CMS, CPT, ICD-10-CM, and Ventra Health documentation guidelines. - Assign accurate ICD-10-CM and CPT codes specific to orthopedic procedures (e.g., joint injections, fracture care, arthroscopies, spinal surgeries) and apply appropriate modifiers (e.g., -RT, -LT, -59, -XU). - Conduct MIPS reviews with a focus on orthopedic quality measures and performance metrics. - Perform Provider QA for orthopedic documentation and coding accuracy. - Identify and document coding errors, especially those related to musculoskeletal diagnoses and procedures. - Audit orthopedic charts at an average rate of 10–15 charts per hour, ensuring compliance and accuracy. - Support coding management with ortho-specific insights and recommendations. - Assist with client/provider audits, particularly those involving orthopedic practices or surgical centers. - Review work product of new orthopedic coders in training, providing guidance on musculoskeletal coding standards. - Provide feedback to coders on discrepancies in orthopedic coding and documentation. - Alert coding manager to documentation deficiencies related to orthopedic procedures in a timely manner. - Respond to coding questions from designated orthopedic coders. - Maintain confidentiality of all personal, financial, and medical information per HIPAA and Ventra Health policy. Education and Experience Requirements: - High school diploma or equivalent. - RHIT and/or CPC certification or equivalent required. - 1–2 years of experience in medical coding, with orthopedic coding experience strongly preferred. Knowledge, Skills, and Abilities: - Deep understanding of CPT coding for orthopedic procedures, including surgical and non-surgical treatments. - Proficient in ICD-10-CM coding for musculoskeletal conditions (e.g., osteoarthritis, fractures, tendon injuries). - Strong grasp of modifier usage in orthopedic coding (e.g., bilateral procedures, staged surgeries). - Ability to interpret orthopedic documentation and assign accurate codes for diagnosis and procedures. - Familiarity with state/federal regulations and payer-specific guidelines for orthopedic services. - Flexible and collaborative in a fast-paced orthopedic coding environment. - Professional communication skills with providers, coders, and auditors. - Knowledge of orthopedic medical terminology and anatomy (e.g., joints, bones, ligaments). - Strong organizational and time management skills. - Basic proficiency in Microsoft Outlook, Word, Excel, and billing software (with proficiency expected within 4 weeks). Ventra Health: Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. Recruitment Agencies Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes. Solicitation of Payment Ventra Health does not solicit payment from our applicants and candidates for consideration or placement. Attention Candidates Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters. To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. Statement of Accessibility Ventra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. 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