Medical Billing/Coding Specialist

CPC (Certified Professional Coder) certification required.
Strong working knowledge of CPT, ASA, and ICD-10 coding guidelines.
Experience with medical billing, insurance follow-up, and claims resolution.
Excellent attention to detail and organizational skills.
Strong verbal and written communication abilities.
Ability to work independently while contributing effectively within a team environment.
Proficiency with electronic billing systems and healthcare software preferred.
Additional Requirements
Maintain strict confidentiality of patient, employee, and organizational information in accordance with HIPAA regulations.
Complete all required compliance, safety, and confidentiality training.
Perform additional duties as assigned by management.

Medical Coding

• Review clinical documentation and accurately assign CPT, ASA, and ICD-10 codes for services rendered.
• Research and obtain necessary documentation from physicians and facilities to support coding accuracy.
• Serve as a coding resource for billing staff by providing guidance on coding questions and discrepancies.
• Follow up with clinical staff regarding missing or incomplete documentation.
• Meet established coding productivity and accuracy benchmarks.
• Maintain coding certification requirements and stay current on industry regulations and updates.
• Perform additional coding-related duties as assigned.

Medical Billing & Accounts Receivable

• Manage insurance and patient accounts through resolution, including follow-up on outstanding balances.
• Investigate, appeal, and resolve denied, underpaid, overpaid, and delinquent claims.
• Respond professionally to patient and insurance inquiries via phone and written correspondence.
• Process insurance and patient refunds according to organizational policies.
• Post insurance and patient payments accurately within the billing system.
• Retrieve and review payment remittances as needed.
• Meet established billing productivity and performance goals.
• Assist with revenue cycle improvement initiatives and account reconciliation activities.