About This Role
The Medical Billing and Coding Specialist is a detail-oriented and energetic professional who accurately codes medical records, processes insurance claims, and ensures the seamless flow of revenue cycle management. This vital role optimizes billing processes, improves claim acceptance rates, and supports the overall financial health of the healthcare organization, contributing to quality patient care through efficient billing and coding practices.
Responsibilities
- Review medical records and documentation to assign appropriate ICD-10, ICD-9, CPT, and DRG codes following medical coding guidelines for inpatient and outpatient services
- Prepare, submit, and follow up on health insurance claims using advanced billing software and electronic health record (EHR) systems
- Ensure accurate coding for all services rendered by applying comprehensive knowledge of medical terminology, procedures, and diagnosis codes
- Manage the revenue cycle by verifying patient insurance coverage, processing third-party billing, and resolving claim denials or rejections promptly
- Maintain meticulous medical records in EMR/EHR systems to support billing accuracy and compliance with healthcare regulations
- Collaborate with healthcare providers to clarify documentation discrepancies and ensure proper coding for optimal reimbursement
- Stay updated on changes in medical coding guidelines, including ICD-10 updates, CPT revisions, and DRG classifications to ensure ongoing compliance
Requirements
- Proven experience in medical office settings with a strong understanding of medical billing, coding, and revenue cycle management
- Proficiency with billing software platforms and electronic health record (EHR) or electronic medical record (EMR) systems
- In-depth knowledge of health insurance claim processing, third-party billing procedures, and insurance verification processes
- Familiarity with ICD-10/ICD-9 coding systems, CPT coding for procedures, DRG classifications, and medical terminology
- Strong understanding of medical records management and adherence to medical coding guidelines for inpatient and outpatient services
- Excellent attention to detail with the ability to interpret complex clinical documentation accurately
- Effective communication skills to collaborate with healthcare providers, insurance companies, and patients as needed
- Medical billing: 1 year (Required)
- Security clearance: Confidential (Required)
Benefits
Important Details
- Expected hours: 35.0 – 40.0 per week
Other Conditions
- People with a criminal record are encouraged to apply