About This Role
This specialist role is crucial for managing the revenue cycle operations of an independent medical practice, ensuring accurate billing and coding to support daily operations and patient care. The position suits a detail-oriented and reliable professional with experience in medical billing and coding.
Responsibilities
- Review and analyze medical records to assign appropriate ICD-10, ICD-9, CPT, and DRG codes in accordance with coding guidelines for inpatient and outpatient services
- Prepare and submit accurate insurance claims utilizing advanced billing software and electronic health record (EHR) systems, ensuring timely processing
- Verify patient insurance coverage, interpret health insurance policies, and facilitate third-party billing to maximize reimbursements
- Maintain detailed documentation of medical records, coding decisions, and billing transactions to support audits and compliance requirements
- Collaborate with healthcare providers to clarify documentation discrepancies and ensure accurate coding for all services rendered
- Manage the revenue cycle by following up on unpaid claims, resolving denials, and conducting collections for outstanding balances
- Stay current with updates in medical coding guidelines, including ICD-10/ICD-9 transitions, CPT coding changes, and regulations related to DRG assignments
Requirements
- Proven experience in medical billing and coding within a healthcare setting, with a strong understanding of medical terminology and medical records management
- Familiarity with EMR/EHR systems and billing software platforms used for electronic health record management for billing and coding purposes
- Knowledge of health insurance claim processing procedures, including understanding of insurance third-party billing processes
- Strong grasp of medical coding standards such as ICD (International Classification of Diseases), CPT (Current Procedural Terminology), DRG (Diagnosis Related Group), and medical coding guidelines for inpatient services
- Ability to interpret complex medical documentation accurately while adhering to compliance standards
- Prior experience working with revenue cycle management processes to optimize cash flow through effective claim submission and follow-up
- Excellent attention to detail combined with active problem-solving skills to handle denials efficiently
Benefits
About the Company
We are an established, community-focused independent medical practice dedicated to delivering high-quality, personalized care to our patients. We pride ourselves on maintaining a collaborative, respectful workplace culture where team members are valued, and patient care comes first.