CPC Certified Medical Coder Surgery (US Healthcare)

Job Title: Medical Coder – Surgery (US Healthcare)

Location: Gurgaon (Remote)
Industry: US Healthcare | Revenue Cycle Management (RCM)

About the Role

We are looking for an experienced Surgery Medical Coder with strong hands-on expertise in coding surgical cases from scratch. The ideal candidate will have deep exposure to either Orthopedic Surgery or Cardiothoracic/Vascular Surgery coding, handling complex procedures with accuracy while ensuring compliance with CMS guidelines, payer policies, and coding regulations.

This role plays a key part in reducing denials and ensuring clean claim submissions for high-impact surgical specialties, including SDS (Same Day Surgery / Ambulatory Surgery) cases.

Must-Have Requirements

• Minimum 2 years of hands-on experience in Surgery Coding from scratch
• CPC certification is mandatory
• Strong expertise in CPT, ICD-10-CM, HCPCS, modifiers, NCCI edits, and CMS guidelines
• Proven experience handling complex surgical claims with minimal errors and denials
• Ability to independently code operative reports and surgical documentation
• Mandatory hands-on experience in at least ONE of the below specialties:

• Orthopedic Surgery OR

• Cardiothoracic / Vascular Surgery

Mandatory Surgical Coding Expertise (Any ONE Required)

1. Orthopedic Surgery Coding

• Joint replacements (Hip, Knee, Shoulder, etc.)
• Fracture repairs
• Arthroscopic procedures
• Spine and spinal fusion surgeries
• Strong understanding of global surgery rules, modifiers, and NCCI edits

OR

2. Cardiothoracic & Vascular Surgery Coding

• Coronary Artery Bypass Grafting (CABG)
• Valve repair and replacement surgeries
• Pacemaker and cardiac device insertions
• Flexible bronchoscopy
• VATS (Video-Assisted Thoracoscopic Surgery)
• Vascular interventions
• Experience with bundled services, add-on codes, and modifier usage

Good-to-Have / Plus Specialties (Not Mandatory)

SDS / Ambulatory Surgery Coding (Highly Preferred)

• Same Day Surgery (SDS) / ASC coding workflows
• Understanding of outpatient surgical bundling and modifiers
• Knowledge of payer-specific outpatient surgery guidelines

OB-GYN Surgery Coding

• Cesarean sections
• Hysterectomies (Open, Vaginal, Laparoscopic)
• Laparoscopic gynecological procedures
• Fertility and reproductive surgeries
• Knowledge of maternity global packages

Gastrointestinal (GI) Surgery Coding

• Diagnostic and therapeutic endoscopic procedures
• Bowel resections
• Hernia repairs
• Bariatric surgeries
• Cholecystectomy
• Upper GI surgical procedures

Key Responsibilities

• Accurately code complex surgical procedures across assigned specialties
• Ensure compliance with CMS, payer policies, and coding guidelines
• Apply appropriate modifiers and resolve bundling issues
• Review operative notes and clinical documentation for coding accuracy
• Support denial reduction through accurate and compliant coding practices
• Maintain productivity and quality benchmarks as per organizational standards

Preferred Skills

• Strong analytical and attention-to-detail skills
• Ability to interpret complex operative reports
• Familiarity with EHR systems and coding tools
• Good communication skills for internal collaboration
• Strong understanding of HIPAA and data security standards

Why Join Us?

• Opportunity to work on high-complexity surgical and SDS cases
• Focused exposure to core surgical specialties (Ortho / Cardio)
• Competitive compensation and growth opportunities
• Supportive and learning-driven work environment