About This Role
This role is for a dedicated and detail-oriented Medical Billing and Coding Specialist who will join a healthcare team. The specialist will ensure accurate coding, billing, and documentation of medical services, facilitating smooth reimbursement processes and maintaining compliance with industry standards. This position offers an engaging environment where skills directly impact the efficiency of healthcare operations and patient satisfaction.
Responsibilities
- Review patient charts, medical records, and encounter forms for completeness and accuracy
- Assign appropriate ICD-10, CPT, and HCPCS codes for podiatry-related procedures and diagnoses
- Submit electronic insurance claims accurately and in a timely manner
- Verify patient insurance eligibility, benefits, and coverage requirements
- Obtain prior authorizations and referrals when required by insurance carriers
- Follow payer-specific guidelines for podiatry billing and coding compliance
- Correct, resubmit, and appeal denied or rejected claims as needed
- Post insurance payments, patient payments, and adjustments accurately
- Reconcile accounts receivable (A/R) and follow up on outstanding balances
- Prepare and send patient billing statements and respond to billing inquiries
- Communicate with insurance companies, patients, and healthcare providers regarding claims and payment issues
- Maintain compliance with HIPAA regulations and healthcare billing standards
- Monitor claim aging reports, reimbursement trends, and billing performance metrics
- Coordinate with podiatrists, clinical staff, and front office personnel to ensure accurate documentation and billing workflows
- Manage billing for common podiatry services including:
- Nail care and debridement
- Diabetic foot care
- Orthotics and durable medical equipment (DME)
- Wound care treatments
- Bunion and hammertoe procedures
- Therapeutic injections
- Diagnostic X-rays
- Stay current with Medicare podiatry billing guidelines, LCD policies, and payer updates
- Utilize EMR/EHR systems, billing software, and clearinghouse platforms efficiently
Requirements
- Knowledge of medical terminology, anatomy, and healthcare documentation
- Understanding of podiatry coding and billing regulations
- Experience with ICD-10, CPT, and HCPCS coding systems
- Familiarity with Medicare, Medicaid, and commercial insurance processes
- Strong attention to detail and organizational skills
- Excellent communication and customer service abilities