Certified Medical Coder / Coding Auditor — Orthopedic & Spine

We are looking for an experienced U.S. medical coder / coding auditor with strong experience in orthopedic, spine, and musculoskeletal physician coding. Our company, MedCode Pro, helps physicians and procedural clinics identify CPT codes, modifiers, add-on codes, and documentation requirements that may have been missed during billing. We are performing audits where we review approximately 60 days of clinic claims and compare the billed codes against the supporting clinical notes. The focus will be orthopedic and spine-related physician services, including clinic visits, procedures, injections, and operative notes. This role is ideal for someone who can read provider documentation and determine what codes are supported, what may have been missed, and what documentation is needed to support the recommendation. Responsibilities - Review de-identified orthopedic and spine-related clinical notes, procedure notes, operative reports, and claim/superbill data - Compare documented services against codes that were actually billed - Identify potential missed CPT codes, add-on codes, modifiers, HCPCS codes, and ICD-10-CM opportunities - Review E/M coding where relevant, including documentation support and modifier use - Flag documentation gaps where a code may be possible but not fully supported - Identify potential undercoding, overcoding, bundling, unbundling, or compliance risks - Provide a clear coding rationale for each recommendation - Summarize findings in a structured audit format Specialty Focus We are especially interested in experience with: - Orthopedic surgery - Spine surgery -Musculoskeletal procedures - Pain-related spine procedures - Injections and procedure coding - Imaging-guided procedures, if applicable - E/M coding for orthopedic clinics - Modifiers commonly used in physician billing - Add-on codes and bundled procedure logic Required Qualifications - Experience with U.S. physician/professional fee coding - Experience coding or auditing orthopedic, spine, or musculoskeletal claims - Strong understanding of CPT, ICD-10-CM, HCPCS, and modifiers - Ability to read clinical documentation and determine what codes are supported - Experience reviewing clinic notes, procedure notes, operative reports, claims, or superbills - Strong written English - Detail-oriented and able to explain coding rationale clearly - Comfortable working with spreadsheets or structured audit templates Preferred Qualifications - CPC, CCS-P, CPMA, or similar certification - Orthopedic coding experience - Experience as a medical coding auditor, ProFee coder, physician coding auditor, or revenue integrity coding specialist - Experience identifying missed CPT codes, add-on codes, modifiers, or undercoding - Experience with NCCI edits, bundling rules, payer rules, denials, or documentation improvement Familiarity with orthopedic/spine coding areas such as: - Arthroscopy - Fracture care - Joint procedures - Spine decompression/fusion procedures - Epidural steroid injections - Facet injections / medial branch blocks - Radiofrequency ablation - Trigger point / joint injections - Durable medical equipment, braces, or orthotics, if applicable We are not looking for someone who only has experience with basic billing, charge entry, payment posting, or AR follow-up. We need someone who can independently review documentation and answer: “Based on this orthopedic or spine note, what could have been coded, what was missed, and what documentation supports the recommendation?”