Overview
This role is well suited for someone with a medical billing/coding background who is comfortable reviewing documentation, coding accurately, submitting high volumes of professional claims, and resolving billing issues while working both independently and collaboratively.
Responsibilities
Primary Responsibilities
- Review, manage and submit 75-100 CMS-1500 professional claims each day
- Assign accurate procedure and diagnosis codes
- Verify claim accuracy before submission
- Review medical records to determine appropriate ICD-10 and CPT codes
- Coordinate with other departments to obtain missing documentation
- Resolve claim rejections and make claim corrections
- Collaborate with revenue cycle teams to understand payer-specific billing guidelines and state insurance requirements
Qualifications
Key Qualifications
- Certificate or diploma from an accredited medical billing/coding program
- Professional coding certification (required)
- Knowledge of ICD-10 and CPT coding
- Strong attention to detail and accuracy
- Ability to multitask and prioritize work
- Strong analytical and comprehension skills
- Excellent verbal and written communication
- Intermediate proficiency in Microsoft Excel
- Work independently while maintaining timely communication with management
- Positive attitude and ability to work collaboratively
- Ability to consistently meet deadlines
Preferred Experience
- Medical billing and coding experience with CMS-1500 professional claims
- Knowledge of insurance policies and reimbursement processes
- Experience with out-of-network medical billing
Skills That Would Make a Strong Candidate
- Medical billing and coding
- ICD-10-CM and CPT coding
- Revenue cycle management
- Insurance verification and payer policies
- Claim denial and rejection resolution
- Medical records review
- Microsoft Excel
- Time management
- Attention to detail
- Communication and teamwork
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