Medical Billing and Coding Specialist

Key Responsibilities

• Assign accurate ICD-10-CM, CPT, and HCPCS Level II codes for diagnoses, procedures, and services based on clinical documentation.
• Review and interpret physician notes, operative reports, and other medical records to ensure coding accuracy.
• Prepare, review, and submit clean claims to commercial insurance, Medicare, Medicaid, and other third-party payers.
• Verify patient insurance, eligibility, benefits, and authorization requirements prior to claim submission.
• Analyze and appeal denied or underpaid claims, resubmitting correct claims as needed.
• Follow up on unpaid claims and outstanding accounts receivable (A/R) in a timely manner.
• Work with payers to resolve billing discrepancies and expedite payments.
• Maintain up-to-date knowledge of coding guidelines, payer policies, and healthcare regulations (HIPAA, CMS, etc.).
• Provide coding and billing support to healthcare providers and administrative staff.
• Document all billing and coding activities accurately within practice management and EHR systems.

Requirements

• Previous experience in medical billing, medical coding, revenue cycle management, or related healthcare role.
• Associate's or Bachelor's degree in Health Information Management, Medical Coding, or related field is preferred.
• Active certification such as CPC (Certified Professional Coder), CCS (Certified Coding Specialist), CRC, CIC, or AHIMA credential is preferred.
• Proficiency in ICD-10-CM, CPT, HCPCS Level II, and medical terminology.
• Understanding of claim submission processes, payer requirements, and reimbursement methodologies (fee-for-service, value-based, etc.).
• Experience with practice management systems, EHR/EMR platforms (Epic, Cerner, Allscripts, NextGen, or similar) and billing software.
• Familiarity with commercial payers, Medicare, Medicaid, and denial management processes.
• Solid understanding of HIPAA, CMS guidelines, and medical coding ethics.
• Impeccable accuracy with the ability to spot coding errors and billing discrepancies.
• Strong problem solving skills with the ability to research and resolve claim denials.
• Clear written and verbal communication skills with the ability to research and resolve claim denials.

Benefits

• Work from anywhere
• Competitive pay
• Flexible schedule
• Supportive and collaborative environment
• Opportunities for growth and advancement

Compensation