Our mission at The Georgia Institute For Plastic Surgery is to be the practice of choice providing the highest quality care at the most reasonable cost, with service that goes beyond the expectations of those we serve. We are seeking a detail-oriented and experienced Certified Medical Coder to join our Billing department.
Job Summary
We are seeking an experienced Certified Medical Coder with strong medical billing experience and advanced expertise in global surgery billing for a high-volume plastic and reconstructive surgery practice. This role supports a commercial-payer-dominant book of business, requiring in depth familiarity with payer-specific global surgery rules, modifier application, and documentation standards.
The ideal candidate has hands-on experience working with major commercial payers such as Blue Cross Blue Shield (BCBS), UnitedHealthcare (UHC), Cigna, and Aetna, and understands how variations in global periods, contract terms, and medical policies impact reimbursement.
Key Responsibilities
- Accurately assign CPT, ICD-10-CM, HCPCS, and surgical modifiers for plastic and reconstructive procedures in an onsite, commercial-heavy environment.
- Apply payer-specific global surgery rules, recognizing differences among BCBS, UHC, Cigna, Aetna, and other commercial carriers as well as government payers.
- Determine billable vs bundled services during global periods, including staged procedures, complications, and unrelated postoperative care.
- Apply and defend appropriate use of modifiers 24, 25, 57, 58, 78, and 79 based on payer policy and documentation.
- Review operative reports, postoperative visits, and E/M documentation to ensure compliance with commercial payer medical policies and contract terms.
- Collaborate closely with physicians and onsite billing staff to resolve coding and global-related billing issues in real time.
- Assist with appeals and reconsiderations related to global surgery, modifier denials, and medical necessity determinations.
- Identify payer-specific denial trends and recommend workflow or documentation improvements.
- Participate in internal audits focused on modifier accuracy, global period compliance, and commercial payer risk.
Qualifications
- Required certification: CPC (AAPC or AHIMA credentials).
- Minimum 2–3 years of combined coding and medical billing experience, with direct experience billing global surgical services for commercial payers.
- Demonstrated experience coding for plastic surgery or other surgical specialties.
- Working knowledge of BCBS, UHC, Cigna, Aetna, and similar commercial payer policies.
- Proven ability to manage modifier-driven and global-period denials.
- Familiarity with prior authorizations, payer medical policies, and postoperative billing workflows.
- Proficiency with EHR and billing systems (e.g., Nextech, EncoderPro).
- Excellent communication, organizational, and analytical skills.
- Onsite availability required (this position is not remote).
Pay: From $27.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
License/Certification:
- Certified Professional Coder (Required)
Location:
Work Location: Remote
