Coding & Billing Specialist

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Job Type

Full-time

Description

PRIMARY PURPOSE:

A Coding & Billing Specialist is responsible for reviewing patient medical records, accurately assigning diagnosis and procedure codes (ICD-10 and CPT) based on established coding guidelines, ensuring compliance with federal and state regulations, and contributing to the accurate billing and reimbursement of healthcare services provided to patients, requiring a current Certified Professional Coder (CPC) certification.

Requirements

PRIMARY PURPOSE:

A Coding & Billing Specialist is responsible for reviewing patient medical records, accurately assigning diagnosis and procedure codes (ICD-10 and CPT) based on established coding guidelines, ensuring compliance with federal and state regulations, and contributing to the accurate billing and reimbursement of healthcare services provided to patients, requiring a current Certified Professional Coder (CPC) certification.

RESPONSIBILITIES:

• Thoroughly review patient medical records, including physician notes, lab results, imaging studies, and operative reports to extract relevant clinical information for coding.
• Accurately assign ICD-10 diagnosis codes and CPT procedure codes based on the patient's medical condition and procedures performed, following established coding guidelines and regulations.
• Ensure the correct sequencing and application of codes, considering modifiers, when necessary, to accurately reflect the complexity of the patient's medical case.
• Stay updated on current coding guidelines, regulations, and industry changes to maintain compliance with federal and state healthcare laws.
• Identify any missing or unclear documentation in medical records and communicate with healthcare providers to clarify information for accurate coding.
• Participate in internal quality audits to monitor coding accuracy and identify areas for improvement.
• Collaborate with in the billing department to ensure timely and accurate submission of claims to insurance companies.

REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

• Comprehensive understanding of medical terminology and anatomy.
• High level of accuracy and meticulous attention to detail to ensure correct coding.
• Ability to analyze medical records and interpret clinical information to assign appropriate codes.
• Effective communication with healthcare providers to clarify documentation and address coding inquires.
• Ability to work effectively, both independently and with a team
• Ability to handle confidential information with discretion.

WORK ENVIRONMENT:

• Full-time, hybrid position (combination of in-office and remote work)

PHYSICAL REQUIREMENTS:

• Ability to endure short, intermittent, and/or long periods of sitting and/or standing in performance of job duties.
• Ability to occasionally to travel to off-site locations and attend meetings, workshops, seminars plus travel to other departments and conference rooms.

MINIMUM QUALIFICATIONS:

• Current Certified Professional Coder (CPC) certification from the American Academy of Professional Coders (AAPC).
• At least 1 year of medical coding experience
• Familiarity with electronic health records (EHR) systems and Epic coding software.

BENEFITS:

• Medical, Dental, Vision, Life, STD/LTD
• Retirement plan with Company match
• Generous Paid Time Off
• Company-Paid Holidays
• Opportunities for professional growth
• Career Advancement