Medical Billing and Coding Specialist

About This Role

The Medical Billing and Coding Specialist is responsible for accurately coding medical procedures and diagnoses, managing billing processes, and ensuring timely reimbursement from insurance providers. This vital role streamlines revenue cycle management, improves patient record accuracy, and supports overall operational efficiency.

Responsibilities

• Review and analyze medical records to assign appropriate ICD-9, ICD-10, CPT (Current Procedural Terminology), and DRG (Diagnosis-Related Group) codes for diagnoses and procedures
• Prepare and submit accurate claims using Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems to insurance companies and third-party payers
• Follow up on unpaid or denied claims through effective medical collection strategies
• Ensure compliance with healthcare regulations, coding guidelines, and payer policies
• Maintain detailed documentation of billing activities, coding decisions, and correspondence with insurance providers
• Collaborate with healthcare providers to clarify diagnoses or procedures as needed for accurate coding
• Stay updated on changes in medical terminology, coding standards, and insurance requirements to ensure ongoing compliance

Requirements

• Proven experience in medical billing, coding, or related healthcare administrative roles
• Strong knowledge of 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
• Ability to interpret medical records accurately and assign appropriate codes efficiently
• Excellent attention to detail and organizational skills to manage multiple claims simultaneously

Nice to have:

• Prior experience in a medical office setting