We are seeking a highly organized, dependable, and detail-oriented Medical Billing and Coding Specialist to support a busy medical practice. We are looking for someone who is comfortable managing a high-volume billing workload, ensuring accurate medical coding and claim submission, communicating professionally with insurance companies and patients regarding billing matters, and helping maximize timely reimbursement while maintaining compliance with payer and regulatory guidelines.
The ideal candidate will have experience with medical coding, insurance claims, payment posting, claim follow-up, denial management, and accounts receivable. This role requires exceptional attention to detail, strong analytical and problem-solving skills, and the ability to manage multiple priorities while meeting billing deadlines.
This position begins part-time and in person. For the right person, there is opportunity for growth into a full-time role with increased flexibility.
Responsibilities
- Accurately assign ICD-10-CM, CPT, and HCPCS codes based on provider documentation while ensuring compliance with coding guidelines.
- Review medical documentation for completeness and accuracy prior to claim submission.
- Prepare, review, and submit electronic and paper insurance claims in a timely manner.
- Monitor claims through the reimbursement cycle and resolve claim edits, rejections, and denials.
- Follow up on outstanding insurance claims and accounts receivable to ensure timely payment.
- Investigate and appeal denied or underpaid claims by gathering supporting documentation and communicating with insurance carriers.
- Post insurance payments, patient payments, adjustments, and reconcile billing discrepancies.
- Verify insurance eligibility, benefits, and coverage when necessary to support accurate billing.
- Work closely with providers and clinical staff to resolve coding or documentation issues that impact reimbursement.
- Identify billing trends, coding discrepancies, and opportunities to improve revenue cycle performance.
- Maintain accurate patient billing records and document claim activity within the practice management system.
- Respond professionally to patient billing inquiries and assist with payment questions or account resolution.
- Stay current with payer policies, coding updates, commercial insurance regulations, and compliance requirements.
- Assist with month-end reporting, accounts receivable review, and other revenue cycle management activities as needed.
- Perform other billing, coding, and administrative duties as assigned to support the practice.
Requirements
- Proven experience in medical billing and coding within a physician practice, specialty clinic, or healthcare organization.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
- Experience working with commercial insurance, workers' compensation, and other third-party payers.
- Proficiency with electronic health records (EHR/EMR) and medical practice management software.
- Strong computer skills, including Microsoft Office (Word and Excel) and Google Workspace.
- Excellent attention to detail with the ability to identify coding and billing errors.
- Strong analytical and problem-solving skills.
- Ability to maintain confidentiality and comply with HIPAA regulations.
- Demonstrated customer service and communication skills when working with patients, providers, and insurance representatives.
- Excellent organizational and time management skills with the ability to prioritize work in a fast-paced environment.
- Bilingual abilities are a plus.
Required Qualifications
- Minimum of 2 years of experience in medical billing and coding.
- Working knowledge of ICD-10-CM, CPT, and HCPCS coding principles.
- Experience submitting insurance claims, posting payments, managing denials, and following up on accounts receivable.
- Knowledge of Medicare, Medicaid, commercial insurance plans, workers' compensation, and payer-specific billing requirements.
- Experience identifying and correcting claim errors to maximize reimbursement.
- Familiarity with medical terminology, anatomy, and clinical documentation.
- Strong written and verbal communication skills.
- Exceptional attention to detail and commitment to accuracy.
- Ability to work independently while collaborating effectively with providers and office staff.
- Strong proficiency with EMRs, billing software, clearinghouses, and revenue cycle management systems.
Preferred Qualifications
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), Certified Professional Biller (CPB), or equivalent certification.
- Experience in a high-volume specialty medical practice.
- Experience with revenue cycle management, denial prevention, and payer audits.
- Knowledge of modifier usage, National Correct Coding Initiative (NCCI) edits, and compliance guidelines.
- Bilingual skills are a plus.
Pay: $20.00 - $25.00 per hour
Benefits:
Experience:
- Medical billing: 2 years (Required)
- Insurance verification: 2 years (Required)
- Prior Authorization: 2 years (Required)
- Medical coding: 2 years (Preferred)
Language:
Work Location: In person
