Summary
The Medical Biller/Coder possesses a valid medical coding certification (CPC) and has solid experience in accurately coding surgery related patient services. The Medical Biller/Coder will perform billing, coding, and collections tasks.
Essential Duties and Responsibilities
-
Review provider documentation for coding appropriateness and accuracy. Codes patient services, enters appropriate CPT codes, and gathers modifiers from supporting documentation.
-
Examine information about patient treatment, diagnosis, and procedures to ensure proper coding guidelines are met.
-
Follow up on claim status to confirm whether accepted or denied at clearing house level.
-
Researches and corrects all rejections at the clearing house level.
-
Monitor and advise on how to optimize billing, coding, and collection procedures to improve the efficiency of the billing and collection processes.
-
Analyze trends impacting charges, coding, collection, and accounts receivable and advise or take appropriate action to optimize processes and procedures.
-
Performs other duties as directed or assigned.
Qualifications
-
Certified Professional Coder (CPC or CPC-A) is required
-
Minimum 3-5 years medical coding experience – surgery coding knowledge required
-
Advanced knowledge of medical terminology, billing processes, and matching insurance documentation to support the coding process
-
Ability to effectively understand, follow, and communicate oral and written instructions in English. Must read, write, and speak English fluently to ensure clear work-related communication and patient safety.
-
Exceptional analytical and problem-solving skills
-
Complete understanding of and working experience using various medical billing software and systems
