Medical Billing and Coding Specialist

We are looking for a detail-oriented and knowledgeable Medical Billing and Coding Specialist to join our healthcare team. In this role, you will manage patient billing, process insurance claims, and ensure accurate coding for medical procedures and diagnoses.

Key Responsibilities:

• Accurately assign ICD-10, CPT, and HCPCS codes to patient diagnoses and procedures based on medical documentation. Ensure coding complies with current regulations and guidelines.
• Prepare and submit insurance claims, ensuring all necessary information is included for accurate processing and payment. Address and resolve any issues related to claims rejections or denials.
• Monitor and track the status of submitted claims, follow up with insurance companies and patients on unpaid or denied claims, and work to resolve any discrepancies.
• Generate and review patient statements, process payments, and handle billing inquiries. Provide clear explanations of charges to patients and address any billing-related concerns.
• Review and verify medical records and documentation to ensure accuracy and completeness before coding and billing. Ensure all documentation meets regulatory and compliance standards.
• Stay updated on changes in coding and billing regulations, payer policies, and industry best practices. Ensure all practices adhere to legal and ethical standards.
• Generate and analyze billing and coding reports to identify trends, discrepancies, and areas for improvement. Prepare reports for management as needed.
• Act as a liaison between the facility, insurance companies, and patients to facilitate smooth claims processing and resolution of issues. Communicate effectively to address any billing-related inquiries.
• Conduct regular audits of billing and coding practices to ensure accuracy and compliance. Address and correct any identified issues or discrepancies.
• Participate in ongoing training and professional development to maintain certification and stay current with industry changes and advancements.

• Certification in medical billing and coding (e.g., CPC, CCS, or similar) is required.
• Proven experience in medical billing and coding, with a strong understanding of ICD-10, CPT, and HCPCS coding systems.
• Familiarity with electronic health record (EHR) systems and medical billing software.
• Excellent attention to detail and organizational skills.
• Strong analytical and problem-solving abilities.
• Knowledge of healthcare regulations, compliance, and payer requirements.
• Ability to work independently and manage multiple tasks in a fast-paced environment.