About This Role
The Medical Billing and Coding Specialist is a detail-oriented and proactive professional responsible for accurately coding medical procedures and diagnoses, managing billing processes, and ensuring seamless revenue cycle management. This role helps optimize insurance claim processing, improve cash flow, and maintain compliance with medical coding guidelines, contributing to efficient healthcare operations.
Responsibilities
- Review and assign appropriate ICD-10, ICD-9, CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes to medical records based on detailed documentation
- Ensure accurate billing for inpatient and outpatient services in accordance with medical coding guidelines
- Process health insurance claims efficiently using advanced billing software and verify coverage details through third-party payers
- Manage electronic health record (EHR/EMR) systems for billing, coding, and medical records management
- Collaborate with healthcare providers to clarify documentation discrepancies and improve coding accuracy
- Conduct follow-up on unpaid or denied claims, performing medical collection activities to recover revenue
- Maintain comprehensive records of coding decisions, billing transactions, and insurance communications to support audits and compliance reviews
Requirements
- Proven experience in medical office settings with a strong understanding of medical terminology, records management, and health insurance processes
- Proficiency with billing software, EMR/EHR systems, and electronic health record management for billing and coding purposes
- In-depth knowledge of medical coding guidelines including ICD-10, ICD-9, CPT coding, DRG classifications, and coding for inpatient services
- Familiarity with health insurance claim processing, third-party billing procedures, and revenue cycle management strategies
- Strong attention to detail with the ability to interpret complex medical documentation accurately
- Excellent communication skills for collaborating with healthcare providers, insurance companies, and patients when necessary
Nice to have:
- Certification in Medical Coding (such as CPC or CCS)
Benefits
- Employee discount
- Flexible schedule
About the Company
This position offers an exciting opportunity to contribute to efficient healthcare operations while working with cutting-edge EMR (Electronic Medical Records) and EHR (Electronic Health Record) systems.