Job Overview
We are seeking a detail-oriented and experienced Orthopedic Medical Biller to join our healthcare team. The ideal candidate will be responsible for submitting claims, ensuring accurate, optimal coding, and maintaining compliance with healthcare regulations. This role offers an opportunity to work in a dynamic medical office environment, utilizing your expertise in medical coding and billing systems to support efficient revenue cycle management. Applicants should have a strong understanding of medical terminology, coding procedures, and electronic health record systems.
Duties
- Performs all coding functions, including CPT/HCPCS and ICD 10 code assignment in accordance with state, federal, and payer guidelines:
- Reviews medical record to ensure appropriate codes are utilized and documentation supports code use
- Assigns appropriate CPT, HCPCS, ICD-10 codes along with appropriate modifiers to capture service rendered
- Queries physicians and medical ancillary staff when necessary for clarification
- Verify patient insurance coverage and eligibility prior to billing
- Review medical records and documentation to ensure accuracy for billing purposes
- Maintain and update patient billing records within ModMed EMR system
- Ensure compliance with healthcare regulations and payer requirements
- Collaborate with clinical staff to clarify documentation discrepancies
- Generate reports related to billing activities and revenue cycle performance
Skills
- RHIT, CPC, or CCS is required.
- Proficiency in medical billing and coding, including CPT, ICD-9, ICD-10, ICD coding, and DRG systems
- Knowledge of insurance and governmental programs, regulations and billing processes (e.g., CMS, Anthem, UHC, etc)
- Experience with EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems, the ideal candidate will have worked with the ModMed EMR system
- Strong knowledge of orthopedic medical terminology
- Ability to interpret complex medical documentation for accurate coding
- Familiarity with healthcare regulations related to billing and collections
- Excellent organizational skills with attention to detail
- Effective communication skills for liaising with insurance companies, patients, and healthcare providers
- Prior experience in an orthopedic surgery practice is strongly preferred
Benefits
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Pay: $23.00 - $26.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Experience:
- Orthopedic surgery Coding: 1 year (Required)
License/Certification:
- Coding Specialist Certification (Required)
Work Location: In person
