Medical Billing/Coding Specialist

Job Description

Job Description

Medical Biller & Coder

Full-Time | Direct Hire | $24–$27/hour DOE + Overtime Opportunity | Onsite

Our client is experiencing significant growth, expanding from approximately 18 locations to more than 60 offices across 18 states. We are seeking experienced, energetic Medical Billers & Coders to join their growing Revenue Cycle team.

This is an excellent opportunity for someone with experience across medical billing, coding and insurance follow-up who enjoys working in a fast-paced physician practice environment. The ideal candidate takes ownership of their work, knows how to research difficult claims and denials, and is comfortable working across the revenue cycle to ensure claims are coded, billed and resolved accurately.

Key Responsibilities

• Review medical documentation and accurately assign appropriate CPT, ICD-10-CM codes and applicable modifiers
• Review claims for accuracy, completeness and appropriate coding prior to submission
• Manage billing and insurance follow-up for a high-volume, multi-physician practice
• Submit and follow up on Workers' Compensation and commercial insurance claims
• Research unpaid, underpaid, rejected and denied claims to identify root causes and determine appropriate resolution
• Review EOBs, payer responses and claim status information and take appropriate corrective action
• Correct coding and billing errors and resubmit claims when necessary
• Research and resolve coding-related denials, edits and rejected claims
• Work claim-cleanup initiatives, including complex payer and reimbursement issues
• Identify documentation, coding or billing discrepancies that may impact reimbursement
• Review and code in-office imaging and other physician-based services
• Follow up with insurance carriers regarding outstanding accounts and reimbursement issues
• Identify denial trends and escalate recurring payer, coding or billing issues
• Work closely with providers, Revenue Cycle leadership and other billing/coding team members to resolve claim discrepancies
• Maintain detailed account notes documenting follow-up and resolution
• Follow claims through final resolution, rather than simply completing the initial billing or follow-up
• Maintain productivity and accuracy standards in a high-volume environment
• Stay current on coding guidelines, payer requirements and reimbursement changes

Qualifications

• Minimum 1+ year of hands-on medical billing, coding, insurance follow-up or physician A/R experience
• Experience working within a physician practice, ambulatory surgery center or similar outpatient environment strongly preferred
• Working knowledge of CPT and ICD-10-CM coding
• Understanding of the medical billing and reimbursement cycle
• Experience researching and resolving insurance denials, rejected claims and aged A/R
• Ability to interpret EOBs, payer correspondence and claim status information
• Ability to research issues independently and follow claims through resolution
• Strong attention to detail and communication skills
• Self-motivated, accountable and comfortable working independently in a fast-paced environment
• Experience with eClinicalWorks is a plus; candidates with other EMR/practice management system experience will also be considered

Highly Preferred Experience/Experience in any of the following areas is especially valuable:

• Ambulatory Surgery Centers (ASC)
• Interventional spine or pain management
• Orthopedic or spine physician practices
• High-volume, multi-physician practices
• In-office imaging
• Workers' Compensation billing/coding
• Commercial insurance
• Complex denial management and A/R cleanup

Schedule

• Monday–Friday
• Standard schedule: 8:00 AM–5:00 PM
• Candidates interested in a 9:00 AM–6:00 PM schedule may also be considered to help support West Coast locations
• Onsite position

Benefits

• 401(k)
• 401(k) matching
• Health insurance
• Dental insurance
• Vision insurance
• Paid time off
• Flexible schedule