Coder II

At OrthoVirginia, you’re part of a team dedicated to delivering expert orthopedic and therapy care across the state. As Virginia’s largest provider of musculoskeletal care, we offer full-time and part-time opportunities in a collaborative, team-oriented environment.

With more than 159 physicians in over 35 locations—including Lynchburg, Northern Virginia, Richmond, Southwest Virginia, and Hampton Roads—OrthoVirginia is a leader in orthopedic surgery, non-surgical care, and physical, hand, and occupational therapy. Our nationally recognized specialists treat a full range of musculoskeletal injuries and conditions, helping patients of all ages move, heal, and thrive.

Join us and become part of a trusted network committed to excellence in orthopedic care.

The Coder II is a coding professional responsible for reviewing and validating complex clinical documentation and coding assignments, with a preferred focus on orthopedic and surgical procedures. This role requires advanced knowledge of coding guidelines, payer policies, and surgical terminology, and plays a key part in ensuring coding accuracy, regulatory compliance, and optimal reimbursement. The Coder II also serves as a resource for junior coders and contributes to process improvement initiatives within the revenue cycle team.

Primary Responsibilities

· Review clinical documentation and diagnostic results to assign accurate ICD-10-CM and CPT codes.

· Code outpatient services including diagnostics, recurring visits, and procedures performed in orthopedic settings.

· Ensure coding supports reimbursement, medical necessity, and regulatory compliance.

· Collaborate with providers and clinical staff to clarify documentation and resolve coding discrepancies.

· Monitoring payer-specific authorization requirements and support appeals when authorizations are not obtained timely.

· Submit appeals with supporting documentation when oversight occurs, requesting reconsideration based on medical necessity.

· Understand payer contracts and recognize limitations in appeal success due to provider-side authorization delays.

· Maintain up-to-date knowledge of coding guidelines, payer policies, and regulatory changes

· Contributes accurate reporting for morbidity, mortality, research, and statistical analysis.

· Participate in meetings and training sessions to support continuous improvement and compliance.

· Serve as a mentor or resource to Coder I team members, offering guidance on complex coding scenarios and best practices.

· Maintain thorough documentation of coding activity and adhere to departmental standards for timeliness and accuracy.

Minimum Qualifications

· Certification: CPC, CCS, or equivalent coding credential (active and in good standing).

· Experience: Minimum 3 years of professional coding experience, with demonstrated expertise in orthopedic and surgical coding.

· Education: High school diploma or equivalent required; associate degree or higher in health information management or related field preferred.

· Advanced understanding of anatomy, medical terminology, and surgical procedures across orthopedic and related specialties.

· Proficiency with electronic health record (EHR) systems and coding software.

Preferred Skills

· Strong working knowledge of Microsoft Office products, especially Word, Excel, and Teams.

· Ability to interpret complex clinical documentation and apply nuanced coding guidelines with precision.

· High level of attention to detail, critical thinking, and problem-solving skills.

· Familiarity with payer-specific rules, inclusive billing practices, and appeals processes.

· Effective communication and collaboration skills across multidisciplinary teams.

· Commitment to professional development and staying current with industry changes and regulatory updates.

Compensation Range for this position:

Compensation for this role will be based on several factors, including the candidate's qualifications, relevant experience, education, skills, certifications, geography/market, and internal equity considerations.

This organization participates in e-Verify. Esta organización participa en e-Verify.