Top 2 Risk adjustment coder Jobs in Exton Pa

Certified Professional Coder
Regional Medical Management Services LLC —Wilmington, DE
- $22 - $28 an hour
- Full-time
- Anatomy knowledge
- Mid-level
- Office
- Health insurance
- Dental insurance
Quick Apply
Accounts Receivable (A/R) Specialist
Regional Medical Management Services LLC —Wilmington, DE
- Full-time
- HIPAA
- Mid-level
- Continuous improvement
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Certified Professional Coder

Regional Medical Management Services LLC
Wilmington, DE

Quick Apply

Job Details

Full-time
$22 - $28 an hour

Benefits

Health insurance
Dental insurance
401(k)
Flexible spending account
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Anatomy knowledge
Practice management software
Patient management software
High school diploma or GED
Clinical documentation improvement

Full Job Description

Position Summary

The Certified Orthopedic Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS Level II codes for orthopedic-related diagnoses, procedures, and services. This role requires deep knowledge of musculoskeletal anatomy, surgical techniques, and orthopedic subspecialties to ensure compliant coding, optimal reimbursement, and adherence to payer and regulatory guidelines. The coder works closely with physicians, clinical staff, and billing teams to support clean claims, audit readiness, and revenue integrity.

Key Responsibilities
Coding & Documentation
Assign accurate ICD10CM, CPT, and HCPCS codes for orthopedic outpatient, inpatient, and surgical services
Code complex orthopedic procedures including:

~Joint replacements

~Arthroscopy

~Spine procedures

~Fracture care

~Sports medicine procedures

Ensure coding reflects correct laterality, encounter type, global periods, and modifiers (e.g., 26, TC, 50, 59, LT/RT)
Compliance & Quality
Maintain compliance with CMS, AMA, payerspecific, and regulatory coding guidelines
Participate in internal and external audits; address findings and implement corrective actions
Stay current with annual coding updates, NCCI edits, LCDs/NCDs, and orthopedic coding trends
Identify documentation gaps and proactively query providers when clarification is needed
Collaboration & Support
Work closely with orthopedic surgeons, APPs, and clinical teams to improve documentation quality
Support billing and denial management teams by providing coding clarification and appeal support
Contribute to process improvement initiatives focused on accuracy, efficiency, and compliance
Productivity & Reporting
Meet or exceed established productivity and accuracy benchmarks
Track and report coding issues, trends, and opportunities for improvement
Assist with onboarding and mentoring junior coders as needed
Required Qualifications
Education & Certification

~High school diploma or equivalent required

~Active coding certification, such as:

CPC (AAPC)

CCS (AHIMA)

~Orthopedic coding specialty certification preferred (e.g., COSC)

Experience

~Minimum 2–3 years of orthopedic-specific coding experience

~Demonstrated experience coding operative reports and complex orthopedic cases

~Experience with EHR and practice management systems

Preferred Qualifications

~Experience in high-volume orthopedic or multispecialty practices

~Knowledge of both professional and facility coding

~Prior audit or compliance experience

~Familiarity with value-based care and risk adjustment principles

Skills & Competencies

~Advanced knowledge of musculoskeletal anatomy and orthopedic procedures

~Strong attention to detail with high accuracy standards

~Analytical mindset with the ability to interpret complex clinical documentation

~Excellent written and verbal communication skills

~Ability to work independently while collaborating across departments

~Strong time management and organizational skills

Work Environment
Officebased
Prolonged periods of computerbased work
Fastpaced, deadlinedriven environment requiring sustained accuracy
Performance Metrics
Coding accuracy rate
Productivity benchmarks
Audit outcomes
Denial reduction and clean claim rates
Benefits
401(k)
401(k) matching
Dental insurance
Dependent care flexible spending account
Health insurance
Life insurance
Paid time off
Vision insurance

Quick Apply

Refine Your Search

risk adjustment coder jobs in exton pa

Certified Professional Coder

Accounts Receivable (A/R) Specialist

Other jobs to consider

I want to receive the latest job alert for risk adjustment coder in exton pa

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~Active coding certification, such as:

CCS (AHIMA)

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