About This Role
Translating medical diagnoses, procedures, and services into standardized codes for billing and insurance claims is the core of this vital role. The specialist ensures compliance with industry standards and optimizes revenue cycle management. This position offers an exciting opportunity to contribute to efficient healthcare delivery through precise coding, thorough documentation, and effective communication with payers and providers.
Responsibilities
- Review medical records, documentation, and provider notes to assign appropriate ICD-9, ICD-10 (International Classification of Diseases), CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes for diagnoses and procedures
- Ensure accurate coding of medical records in accordance with current coding guidelines and regulations
- Submit clean claims to insurance companies using Electronic Medical Record (EMR) or Electronic Health Record (EHR) systems, following all billing protocols
- Follow up on unpaid or denied claims through medical collection processes, resolving discrepancies efficiently
- Maintain comprehensive and organized medical records, ensuring all documentation aligns with coding requirements
- Stay updated on changes in medical coding standards, insurance policies, and healthcare regulations to ensure ongoing compliance
- Collaborate with healthcare providers to clarify documentation or resolve coding issues promptly
Requirements
- Athena health EMR knowledge
- Proven experience in medical billing and coding within a healthcare setting
- Strong knowledge of ICD-9, ICD-10, CPT coding systems, and DRG classifications
- Familiarity with medical terminology, medical records management, and healthcare documentation standards
- Experience working with EMR/EHR systems for billing and record keeping
- Excellent understanding of medical billing processes, insurance claim submission, and collections procedures
- Ability to interpret complex medical records accurately and assign appropriate codes accordingly
- Detail-oriented with strong organizational skills to manage multiple claims efficiently
Benefits
- 401(k)
- 401(k) matching
- Flexible schedule
- Retirement plan