Orthopedic Claim Scrubber

3 weeks ago

Metro Manila Philippines Genesis Orthopedics & Sports Medicine Full time

Role Overview

We are seeking a highly skilled Orthopedic Medical Coder and Claim Scrubber with direct EPIC EHR experience to join our growing revenue cycle team. This role is critical for ensuring clean claim submissions, maintaining coding compliance, and maximizing reimbursement for complex orthopedic procedures. You will play a central role in preventing denials and optimizing revenue through detailed review and collaboration with clinical and billing teams.

Key Responsibilities

  • Comprehensive Claim Scrubbing: Review all orthopedic claims for accuracy, completeness, and compliance prior to submission.
  • Specialized Orthopedic Coding: Assign precise CPT, ICD-10, and HCPCS codes for both surgical and clinical orthopedic services, including joint replacements, fracture care, arthroscopies, and sports medicine procedures.
  • EPIC EHR Expertise: Utilize EPIC’s coding and claim processing modules to ensure efficient workflow and documentation accuracy.
  • Compliance & Guidelines: Ensure all claims adhere to payer-specific, federal, and orthopedic coding regulations.
  • Documentation Collaboration: Work with physicians and clinical staff to resolve documentation gaps or discrepancies.
  • Denial Prevention & Analysis: Identify patterns in claim denials specific to orthopedic coding and recommend corrective measures.
  • Continuous Learning: Stay current with orthopedic coding updates, payer policy changes, and new procedural coding requirements.
Required Qualifications
  • Minimum 2 years’ medical coding experience , with strong emphasis on orthopedic coding (surgical and clinical).
  • Proven experience with EPIC EHR for coding and claims management.
  • Familiarity with claim scrubber tools and understanding of revenue cycle workflows .
  • Deep knowledge of orthopedic anatomy, terminology, and procedure coding protocols .
  • Strong analytical skills, attention to detail , and ability to manage multiple priorities.
  • Ability to work independently while effectively communicating with clinical and billing teams.
Important

Applicants must have orthopedic coding and EPIC experience to be considered. Please do not apply if you do not meet these criteria.

Preferred (Not Required)
  • Coding Certification (e.g., CPC, CCS, or equivalent) strongly preferred but not required if orthopedic experience is verifiable.

About Us

Genesis Orthopedics & Sports Medicine delivers world-class orthopedic care to every patient, regardless of insurance status. Our mission is rooted in justice, inclusion, and innovation—reimagining musculoskeletal care to be more accessible, human, and effective.

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