PB Coder III- ORTHO

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Coder III is responsible for reviewing for physician services and interpreting physician documentation, CPT and diagnosis coding, coding claim edit, and coding denial management utilizing ICD-10-CM and CPT-4/HCPCS coding systems. Codes highly complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within established productivity and coding accuracy guidelines. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines complex code assignment pertinent to Emergency Room, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services.

CODER III

The Multispecialty Coder must possess a strong surgical specialty background in some of the following specialties: Neurosurgery, Trauma, Ortho, Plastic Surgery, etc.

Codes complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding.

Evaluates medical record documentation, paper charge, discharge disposition, ICD-10 and CPT coding to optimize reimbursement by ensuring that medical, diagnostic and procedural codes and other documentation accurately reflect and support the visit.

Compiles necessary documentation prior to coding review; when documentation is not available, performs the appropriate steps to obtain the necessary documentation per the department’s policies and procedures.

Works independently to resolve issues, applying root cause analyses to determine steps required for timely resolution. Meets established productivity and accuracy standards.

Demonstrate the ability to communicate effectively and professionally in interactions with physicians, management, and staff.

Queries physicians when code assignments are not straightforward or documentation is inadequate, ambiguous, or unclear for coding purposes; offers physician opportunity to submit corrected documentation.

Notifies appropriate individuals of potential non-compliance with Medical Necessity requirements and when services are non-covered or not payable, as appropriate.

Corrects failed claim errors to billing edits, coding denials, quality management data edits and/or other errors identified through various auditing or billing process.

QUALIFICATIONS:

Four (4) years of coding experience required,

two (2) years of experience must be in a Surgical/Ancillary Diagnostic discipline

or 1 year of experience with specialty coding certification in a Surgical/Ancillary Diagnostic discipline. Knowledge of CPT and ICD-10 coding conventions.

CERTIFICATION: Certified Coding Specialist

Remote: Must live in Georgia

Ability to multi-task, prioritize needs, and meets required timelines.

Good interpersonal and communication skills in dealing with physicians and other healthcare professionals.

Ability to research the root causes related to the inability to code and drop accounts.

Core Competencies
These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes to safe, high-quality care, positive patient experience, and a collaborative work environment.

1. Patient-Centered Care – Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.

2. Integrity & Accountability – Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.

3. Collaboration & Teamwork – Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.

4. Communication – Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.

5. Respect & Inclusion – Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.

6. Quality & Safety – Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.

7. Adaptability & Resilience – Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.

8. Continuous Improvement – Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.

9. Leadership & Professionalism – Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.

10. Employee Experience Focus – Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.

Grady Total Rewards
At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

• Health & Wellness: Medical, dental, vision, and prescription drug coverage.
• Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.
• Work-Life Balance: Paid time off, holidays, and family leave benefits.
• Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.
• Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Grady’s Total Rewards are designed to ensure our employees feel valued, supported, and empowered, both at work and beyond.

Why Join Grady?
Grady Health System is more than a hospital — we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration.

Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued.

At Grady, we don’t just work, we make an impact.

Equal Opportunity Employer Statement:
Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.