Certified Professional Coder Podiatry / Foot & Ankle

ABOUT THE ROLE

Responsible for reviewing clinical documentation to abstract and validate CPT and ICD-10 coding for podiatry-based encounters, including evaluation & management (E/M) and surgical coding. The coder will ensure that medical records are coded accurately and in a timely manner, work closely with physicians and team members to translate clinical documentation into ICD-10 and CPT codes, identify and report error patterns, resolve coding and billing issues, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.

KEY RESPONSIBILITIES

• Review clinical documentation to assign diagnostic and procedural codes for inpatient and outpatient medical records according to the appropriate classification system
• Ensure accurate, timely assignment of ICD-10, CPT/HCPCS, and modifiers for billing, internal and external reporting, research, and compliance with regulatory and payer guidelines
• Monitor documentation turnaround time and productivity; follow up on deferred accounts or with physicians and clinical staff as needed
• Generate reports and analyze data related to E/M code utilization, CPT code application, denials, and reimbursement per contracted terms
• Provide coding feedback to providers, clinical department leadership, and the revenue cycle team
• Escalate coding and documentation issues to revenue cycle leadership and assist facilitating corrective action plans
• Assist with design and implementation of workflow updates and coding tools
• Support the denial team on coding-related denials
• Assist Coding Manager on physician education projects

REQUIREMENTS

• Certified Professional Coder (CPC) or Certified Coding Specialist — Physician Based (CCS-P) required
• Minimum 3 years of coding experience within podiatry and/or foot and ankle orthopedic surgery
• Physician-based coding experience including evaluation & management (E/M) and surgical coding
• Knowledge of federal, state, and payer-specific regulations pertaining to documentation, coding, and billing, with demonstrated ability to interpret such guidelines
• Advanced knowledge in analyzing patient records to identify non-conformances in CPT, ICD-10-CM, and HCPCS code assignment
• Proficient in Excel, Word, and data entry; experience with healthcare billing software such as Modernizing Medicine (ModMed) or EClinical Works a plus
• Strong written and verbal English communication skills
• Proficient touch-typing skills

PREFERRED

• Certified Outpatient Coding (COC) credential
• Wound care coding experience
• Experience working in a BPO environment supporting US healthcare clients
• Familiarity with podiatry-specific billing nuances (nail procedures, DME for orthotics) and orthopedic modifiers (59, 25, LT/RT)
• Prior work with denial analytics or AR follow-up workflows

CORE COMPETENCIES

• Ability to focus for extended periods with high attention to detail
• Ability to manage multiple priorities and projects simultaneously
• Excellent time management skills
• Commitment to continuous learning and professional development

SPROCKET INTERNATIONAL | Confidential