Coding Specialist (Medical Coder)

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. Collaborate with revenue cycle teams to understand payer-specific billing guidelines and state insurance requirements .

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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