Coding Team Lead (Orthopedics)

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

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The Orthopedic Team Lead is responsible for overseeing the accurate review and coding of orthopedic encounter documentation, ensuring all procedures and diagnoses are properly identified and captured.

This role ensures that all encounters are coded accurately and in compliance with the most current coding guidelines and regulatory standards.

The Orthopedic Team Lead must be proficient in identifying incomplete, unclear, or inaccurate clinical documentation and proactively communicate with providers or staff to obtain clarification, ensuring compliant and high-quality coding practices.

Timeliness is essential; therefore, the Orthopedic Team Lead ensures that all encounters are coded and processed within established turnaround times.

The role also includes reviewing orthopedic claims denied by insurance payers, identifying potential coding discrepancies, and implementing necessary corrections to support accurate claim resubmission and reimbursement.

• Review orthopedic medical records to accurately identify all procedures and diagnoses
• Audit coded orthopedic encounters to identify inaccuracies and implement necessary corrections
• Collaborate with the QA team to review and discuss audit findings
• Identify incomplete or inaccurate provider documentation and communicate findings via Smartsheet
• Maintain Smartsheet by documenting updates, tracking issues, and communicating directly with clients regarding patient accounts
• Maintain internal orthopedic coding guidelines, ensuring alignment with current industry standards and updates